Refusing Conventional Treatment

[Guest jangrin]

During the C&P exam yesterday a question of conventinal treatment has come up. The exam doctor asked my husband about his DMII and his symptoms and testing levels.

My husband stated that his sugar levels were high a fluxuated greatly. He also told the C&P that his PCP wanted to start him on insulin this past year. My husband said no because we were going through financial difficulties and we didn't know where we would be living and he didn't want to start a new therapy and then have to stop it, especially something like insulin.

The doctor C&P doc stated that there is a lot of new thought about DMII and insulin and that there was also some new treatments for DMII that might be a possibility. And that he (my husband) should explore those.

If this is the case, and my husband should be rated a 40% to 60% according to his symptoms, but because he has elected to not take the insulin for the DMII, does this mean he only qualifies for the 20% rating in the CFR?

[Guest jangrin]

Please note that my husband was DX with DMII, CAD, arteriosclerosis, ischemic heart disease, hypertension (HBP), and PN all in about 4 weeks time. Then was told he had heart calcium score of 1720, (about 50-100) is normal for a man his age.He was put on about 9 different meds over a three weeks period (which include both oral DMII meds) And failed all the heart stress tests.

Then he has massive gastrointestinal stuff going on and they want to add more DMII meds. He was a bit leary. Now things are settled down and emotionally he is ready to do something. But you cannot believe how this has affected him and our family. We were all very over whelmed about the medical issues and it was topped off with loosing our home and having to move away from our family and friends. Hmmm, I don't think I'll be too upset with him for wanting to wait before he started changing all the meds.

He has not refused DMII meds, he has postphoned starting on the insulin (injections). We didn't even have a reliable place to store the meds let alone be able to have everything monitored.

I apologise if I gave the wrong impression about the meds( Iwas only speaking of the injectable insulin) But I think the VA will say he is not insulin therefore he is 20% SC and that is not entirely the whole story. His PTSD C&P exam is scheduled for 7 days after his first medical appt. in the last few months.

We still recieve medications from the "old" medical center and pharmacy under the supervision of the old doctor over 2000 miles away.

Jangrin

Edited February 10, 2007 by jangrin

[Guest terrysturgis]

jangrin, my DMII is being treated with medications (Avandia and Metformin) and I am rated at 40% for the DMII. Advandia at 8MG and Metformin at 1000MG. Part of the rating is for control of the Diabetes and how it affects your daily activities. I started at 20% when I first filed my claim and appealed for an increase and that's when I got awarded 40%.

As far as everyone's attitude toward DMII control, no one understands the need for exercise and diet than us folks with the disease. With the other medications I take for Neuropathy and HBP I also have to fight depression. Between my wife and my on leave Army daughter, the diet control is mandatory. If I even look at something tasty I get my butt chewed. And my favorite exercise is walking. The temp is a high of 10 degrees with a wind chill of below zero I tend to stay inside. I do use a bike and stair climber that we have downstairs.

Another thing availiable is an insulin pump that maybe someday your husband and I will have to go to something like that.

Philip is clear in that we need to do the right for our families by taking care of our disease. Stress, been there as have you'all but from what I see of the work done by you on your claims will pay dividends when the decision is done. By being on HADIT it gave you the information needed to get the evidence you need to win. I did not find the board till I was well into the process that's why I think you have a better claim than I did and I am 100% P&T. Hang in there and take care. Terry Sturgis

[Guest jangrin]

This was included in one of the links that Berta provided:

it is a new medication for type DMII that may only require once a week or once a month treatment but more importantly.... it HELPS YOUR BODY PRODUCE AND REGULATE ITS OWN INSULIN RATHER than manmade.

Maybe this will be an option as it seems to be more natural and the patient also usually looses weight rather than gains weight as with the use of regular insulin.

http://www.byetta.com/index.jsp?reqNavId=0

Thanks Berta- this is good info--

Edited February 10, 2007 by jangrin

[Josephine]

Please note that my husband was DX with DMII, CAD, arteriosclerosis, ischemic heart disease, hypertension (HBP), and PN all in about 4 weeks time. Then was told he had heart calcium score of 1720, (about 50-100) is normal for a man his age.He was put on about 9 different meds over a three weeks period (which include both oral DMII meds) And failed all the heart stress tests.

Then he has massive gastrointestinal stuff going on and they want to add more DMII meds. He was a bit leary. Now things are settled down and emotionally he is ready to do something. But you cannot believe how this has affected him and our family. We were all very over whelmed about the medical issues and it was topped off with loosing our home and having to move away from our family and friends. Hmmm, I don't think I'll be too upset with him for wanting to wait before he started changing all the meds.

He has not refused DMII meds, he has postphoned starting on the insulin (injections). We didn't even have a reliable place to store the meds let alone be able to have everything monitored.

I apologise if I gave the wrong impression about the meds( Iwas only speaking of the injectable insulin) But I think the VA will say he is not insulin therefore he is 20% SC and that is not entirely the whole story. His PTSD C&P exam is scheduled for 7 days after his first medical appt. in the last few months.

We still recieve medications from the "old" medical center and pharmacy under the supervision of the old doctor over 2000 miles away.

Jangrin

Jangrin,

I can understand your husbands reluntance to the insulin. I posted my story, as I was told that I would be on insulin. Sometimes just a change of diet and a little help from a pill and that is all that is needed to control the diabetes. No it isn't fair to rate you lower if you choose to take a pill versus a shot.

Always,

Josephine

[Guest jangrin]

Jangrin,

I can understand your husbands reluntance to the insulin. I posted my story, as I was told that I would be on insulin. Sometimes just a change of diet and a little help from a pill and that is all that is needed to control the diabetes. No it isn't fair to rate you lower if you choose to take a pill versus a shot.

Always,

Josephine

Josephine,

It really wasn't the pill vs the shot as much as it was once you start the insulin your body becomes dependent and it is very difficult to get off of the medication if the opportunoity arises.

He was hopeing to control it with diet and exercise, but the doctor told him no physical activity that would raise his blood pressure, just as the C&P doctor said yesterday. He can walk and he can ride a bike slowly but he is to avoid stressing physically until after the heart angio is done.

There are just many things going on at once. Every persons situation although similar can be quite different. I am not upset at all about the comments as they are ALL well founded and everyone is concerned about his family which means ME. If I thought for one minute that my husband was intentionally puting his life in more danger, trust me I would KICK HIS BUTT. The truth be known his intentions were to make it to our new home and get settled in without having a heart attack or without being hospitalized because his insulin level got screwed up and he went into a diabetic shock. That was the bottom line. Limit stress and accomplish what we had to accomplish.

We all just felt that at that particular moment the status quo was in order. Now that we are settled in- it is time to move forward and address those issues-

Unforrtunately, we didn't account for the VA back log in Appts. so we are on hold for the moment. I have faith these issues will be addressed once he begins his treatment the first of March with his new primary doctor at the VA.

He lost 30 pounds in 6 weeks iniitally, but becuase of living in a motel for a while trying to find a place to live, the weight has come back on. Now that we are in a home things will hopefully return to some kinds of normal.

I really do appreciate the friendship of all at Hadit and the concerns.

[Josephine]

Josephine,

It really wasn't the pill vs the shot as much as it was once you start the insulin your body becomes dependent and it is very difficult to get off of the medication if the opportunoity arises.

He was hopeing to control it with diet and exercise, but the doctor told him no physical activity that would raise his blood pressure, just as the C&P doctor said yesterday. He can walk and he can ride a bike slowly but he is to avoid stressing physically until after the heart angio is done.

There are just many things going on at once. Every persons situation although similar can be quite different. I am not upset at all about the comments as they are ALL well founded and everyone is concerned about his family which means ME. If I thought for one minute that my husband was intentionally puting his life in more danger, trust me I would KICK HIS BUTT. The truth be known his intentions were to make it to our new home and get settled in without having a heart attack or without being hospitalized because his insulin level got screwed up and he went into a diabetic shock. That was the bottom line. Limit stress and accomplish what we had to accomplish.

We all just felt that at that particular moment the status quo was in order. Now that we are settled in- it is time to move forward and address those issues-

Unforrtunately, we didn't account for the VA back log in Appts. so we are on hold for the moment. I have faith these issues will be addressed once he begins his treatment the first of March with his new primary doctor at the VA.

He lost 30 pounds in 6 weeks iniitally, but becuase of living in a motel for a while trying to find a place to live, the weight has come back on. Now that we are in a home things will hopefully return to some kinds of normal.

I really do appreciate the friendship of all at Hadit and the concerns.

Jangrin,

The first of March will be hear before you know it. Time is passing fast. Keep the stress down and I can tell you are a smart cookie and have things all under control.

Always,

Josephine