ptsd 5yr C&P MH Approaching 5 days Should i worry? Some Questions

[Rx7mike]

In short i was med retired from the army in 2011. Army awarded 100% dissability and i was on SSDI for almost a year before being Retired CH 61.

Va original award was 60% i did a NOD recieved 100% for Bipolar, Severe Anxiety Disorder, Acute TBI, PTSD with Bipolar being The major Issue. I ellected to take the 100% for MH and leave my other contentions ratings to stay the same.

I have made my appointments with my MH dr and it has been a roller coaster. Meds always changed but i am currently on

Lithium 2700mg Day

Diazapam 5 mg 4 times daily as needed

Ziprasidone hcl 80mg 2x day

Divalproex 500mg 24hr

Those are my Daily MH meds.

2 yrs ago i tried multiple times to commit suicide and have constant thoughts but dont act on them. I have a very violent temper especially when i have an anxiety attack its like instead of going into a whole i rather fight. Its hell on my wife and kids i dont go out i avoid social interactions at most costs. My last few visits with my MH Dr she states no suicidal idealations and well dressed and while on medication i am stable. WHILE on Medication i am stable. I recently saw her as i was in a depressed moment and the Hotline reffered me to see her asap.

I have gone after another vet in the parking lot over a parking spot and it escalated to inside the VA im sorry but its hard to control.

My question is I have been unemployed and on ssdi since discharge but my last couple appointments with my MH she states that i am making progress towards my goals but also stated that recently i had an event that i was excited about but then lost my diazapam and my anxiety has increased but subsided when i was able to take it again. I have been kick out of school on 2 seperate ocassions due to conflict within the first semester and she reccomended i donot try school yet. This was over a year ago. i am sorry i am all over the place but i am having trouble keeping my thoughts together.

My question is since i have made my MH appointments and seek treatment even though they have gone to 1 every 3-4 months. I do take my medication as prescribed. My last couple MH appointments have been me slowly reaching my goals but must remain on medication but has annotated slightly aggressive behavior and depression and Hotline contact. I recieved a letter in dec 2014 from ssdi stating they conducted a reveiw and i will remain Disabled. I have highs and lows which have gotten stable over the intial C&P.

Will my recent somewhat normal visits lately affect my C&P and since i am on such high dosages of Strong anti sychotics medications that will cause severe issues if i miss or do not take will that help keep my rating or since they keep me fairly stable at times with tweaking lower my catagory?

I am also smc k if that helps

My VSO said i will most likely be made P&T as she saw my past yr or 2 of DR appointments and incidents. Im just hoping for some more clarification from you guys on this matter.

As far as the 100% criteria i meet 3-4 of the requirements i underlined the ones pertaining

100% rating: This rating will have the majority of the following circumstances and symptoms:

The Ability to Care for Yourself: This individual cannot take care of himself at all. Constant or near-constant hospitalization and one-on-one supervision is required. If not checked on by spouse i do stupid shit i.e. cut mself sometimes i do productive stuff sometimes self destructive

Medications: This individual requires psychiatric medication at all times.

Symptoms: Some or all of the following symptoms will be present.

– Regular or constant delusions or hallucinations and the inability to tell fact from fiction
– Completely inappropriate behavior (like drooling, mumbling, shouting, etc.)
– There is constant danger of hurting self or others (including suicidal tendencies)
– Significant memory loss, including not being able to remember names of close friends, family, or self, and other important information
– The individual cannot understand the idea of time or place
– The individual cannot properly reason, think or communicate logically
– Constant anxiety, fear, suspicion

The Ability to Work: This individual cannot work at all.

Social Relationships: This individual cannot participate in any relationships. In other words, they cannot interact or build a relationship with another person. Family members may care for them, but it is only a one-way relationship. They cannot seek, invite, or encourage any relationships

As for Family members those that live with me wife kids are my only means of contact besides dr ect. I avoid all other interactions as much as much as possible. no kids school functions i dont even talk to neighbors or lifelong freinds unles its via txt .

Thank you for your input any will be helpfull. also will a spouse letter help at all since i know i put my wife through hell. I know i dont mean to but i dont seem to bother me. Again sorry this is in randomly im just trying to write it as the thoughts come to me i dont want to miss anything.

 

[broncovet]

No.  You should not worry.  Go to your scheduled appointment prepared.  

1.  Do not exaggerate any symptoms.  They will smell that and the outcome wont be good.  

2.  Have your answer ready when the doc asks, "How are you?"  Most of us answer "FINE" but this is not the time to UNexaggerate your symptoms, either.  When the doc asks how you are, if you got into a fight about a parking space in the VA parking lot, then tell him this.  Don't say "fine", when you are not.  

If you are "fine" the day of the exam, then tell the examiner what happened Tuesday when you got in a fight with your wife and the cops were called.  Example (Remember, never lie or exaggerate):

DOC:  How are you?

Vet:  "Not as bad as Tuesday."  (or last month). ( Now,Tell him what happened on your worst day, not today if today is your best day.).   "  I got in a fight over a parking spot and the fight moved inside VA.  Im glad nobody got hurt, but I dont know why my anger boils over like this sometimes.   Im not working now, and that could be a good thing, given my suicidal ideations on (date).  Im not real angry today, fortunately, but I never know what could trigger it in an instant.  

When a Vet responds to the question, "fine", he has to backpedal most of the rest of the exam.  Yes, I know most of us were taught not to bore others with our health issues and just answer fine no matter what.  Dont do that.  

Edited March 19, 2016 by broncovet

[Rx7mike]

18 minutes ago, broncovet said:

No.  You should not worry.  Go to your scheduled appointment prepared.  

1.  Do not exaggerate any symptoms.  They will smell that and the outcome wont be good.  

2.  Have your answer ready when the doc asks, "How are you?"  Most of us answer "FINE" but this is not the time to UNexaggerate your symptoms, either.  When the doc asks how you are, if you got into a fight about a parking space in the VA parking lot, then tell him this.  Don't say "fine", when you are not.  

If you are "fine" the day of the exam, then tell the examiner what happened Tuesday when you got in a fight with your wife and the cops were called.  Example (Remember, never lie or exaggerate):

DOC:  How are you?

Vet:  "Not as bad as Tuesday."  (or last month). ( Now,Tell him what happened on your worst day, not today if today is your best day.).   "  I got in a fight over a parking spot and the fight moved inside VA.  Im glad nobody got hurt, but I dont know why my anger boils over like this sometimes.   Im not working now, and that could be a good thing, given my suicidal ideations on (date).  Im not real angry today, fortunately, but I never know what could trigger it in an instant.  

When a Vet responds to the question, "fine", he has to backpedal most of the rest of the exam.  Yes, I know most of us were taught not to bore others with our health issues and just answer fine no matter what.  Dont do that.  

All my incidents are on file and most can be pulled up with Bluebutton. I Do tend to mask my felings as we were taught and know this isnt the time to nor to exassterbate them either. I can be very calculated for a short period but then it turns to shit. The last year of records even though my dr schedule has me in every 3 months some 4 i have been in a different mood or incident on file. I was involved in an altercation 2yrs ago i was sent to the VA hospital for psych hold 72hrs after an incident and was brought to the police station then sent to VA. That is also in my Bluebutton. In ebenefits it has a add more evidence so i sent my last 4yrs of bluebutton in the file. I know they have accesss to that info im just wondering what else i should bring besides my DYSFUNCTIONAL VET BUTT. Spouse will be with me when i go i was already told the C&P will not allow her in so should i get a statement from her and give them a copy from the SSDI that that has been continued due to no future resolution seen?

[broncovet]

If its a problem WRITE DOWN your answer in advance, when you have time to think about it.  So, when the doc asks you, "How are you?" you can respond.  

"I dont like to talk about it, so you can read about it here"  Hand him your paper.   Dont be rude, but its okay if you dont like to talk about your PTSD, triggers, etc.  You should not have to "relive" those events at the docs office when you feel pressured to do so.   Its not a requirement that you tell your PTSD stressor events, for example, to every VA employee, VSO, doc, nurse, sister, brother, neighbor, or grocery store clerk that asks, to get your benefits.  

[broncovet]

Remember, of course not to be rude or evasive in your answers, but you dont have to be redundandt, either.  You can respond,

"If its all the same to you, Doctor, I already went over this with another VA doctor, (dr. smith) 2 weeks ago, and I prefer not to do that all again, as I dont have anything to add to what I already told that doc.  Im not particularly proud of my mental illnesses, but if there are questions about that appointement you need to know I will answer them, but I would rather not rehash what I said then as nothing has changed in the past 2 weeks.   Its very stressfull on me to recall these events and I prefer not to bring em up over and over"

The doc is probably not going to ask you.  "Oh yea, I read that report.  What I need to know is which body organs were hanging out of that corpse you handled, was it the kidneys, the spleen, the large intestines, or were they all ground up with dirt so you could not recognize them?  I also need to know how many seconds it took for that guy to die, or was he already dead when you said you closed his eyes.  Hopefully you timed the exact number of seconds as I need this for my report.   How many liters of blood do you estimate he lost when you first found him?    Im also curious as to the exact way you described this event to your 4 year old daughter, especially because you said it was on Christmas eve."   

Edited March 19, 2016 by broncovet

[Buck52]

 broncovet has good advise here!

I think you will keep your rating AND they may even inferre a SMC H.B  if your awarded T&P

jmo

...........Buck

Edited March 19, 2016 by Buck52

[TexasMarine]

First of all of "what BroncoVet said".  I fully concur.

Also, you may consider your issues (vis-à-vis the VA and the exam), in this manner ...

   Bipolar Disorder is not curable. 

http://www.bipolardisorderscenters.com/is-bipolar-disorder-curable/

    But it can be controlled by taking the proper prescriptions and limiting exposure to potential stressors.  Sometimes, that means staying at home for much of the time.  Many BP sufferers, only go out to see their VA psychiatrist.  Going into the public, and especially "work environments" sets up stressors both "quick and severe", and "slow, long-lasting animosities" that trigger some of the most violent or at a minimum "embarrassing" moments for both the vet and the organization.

   The C&P Doctor, if being truthful, knows these issues, and you need to discuss your concerns with him such as "I'm know I going to (have to) live with this the rest of my life, aren't I doctor?"  I'm sure you've had that discussion with your MH Doctor.

In any case, what BroncoVet said about "not being fine", is absolutely true.  Even if you feel fine, you are NOT, because you have Bi-Polar, as well as other "issues".