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diabetes Long Post: Please Advise.
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Question
Border
I need some assistance.
I was medically separated from the military in 2002 due to a non-combat parachute jump. I incurred a head injury and was dischared with post-concussive syndrome and right sural nerve damage. I received a 20% disability rating.
I presented to my current internist fatigue, difficulty with concentration and short-term memory, polyuria with 3-4 per hour voiding, and polydypsia to the point of near continuous thirst.
I have acquired paperwork from this board-certified internist (medical school at Yale, published, and 30+ plus years experience) and an endocrinologist stating that I have diabetes insipidus. I have extensive paperwork stating that I have this condition.
I was also referred to a memory disorder clinic. The clinic did an extensive neuropsychological work-up concluding that I have difficulty finishing tasks, recalling recent events, concentrating, focusing, neuropathic pain, change in behavior, masked facies, headaches, bilateral gaze-evoked nystagmus, and diabetes insipidus. My intellectual functioning was all above expectations, except for working memory. Memory was below expectations in most areas. Of particular concern was immediate and delayed recall of pictured events. Also, my performance on visual motor constructional tasks was well below expectations given my IQ (which has actually dropped almost 8 points since the military's doctor conducted the same testing). The final diagnosis was closed head injury with post concussive syndrome.
The internist also wrote a letter for my file stating that I face lifelong limitations due to this (the military accident) traumatic brain injury, including: 1) any situation in which he becomes unable to sense thirst or unable to respond by drinking, 2) the memory deficit has created a lack of confidence and profoundly effects inter-personal relationships, 3) treatment with vasopressin for one year at higher than expected doses has produced less than opitimal responses, cannot drink coffee, tea, colas, and any other diruretic beverage, restrictions within my diet that also effect my ability to socialize, 4) career choices will be limited to positions that allow frequent absence from the desk/workstation and close proximity of fluids and restrooms. She continued by stating that I have attempted to maintain functionality with exercise, no alcohol or tobacco, etc. She concludes that since the accident that created the traumatic brain injury, is likely as not that there will be a continued decline in function and working memory which will impact my way of life, potential livihood and inter-personal relationships. She including supporting attachments.
The neurologist at the memory disorder clinic recommended provigil to counter the chronic fatigue and referred me to a research study group at the local universty aimed at helping folks like me improve daily functioning. I also received documentation from that professor. Another neurologist recently placed me on depakote, though the internist took me off of it immediately because I gained almost 20 pounds within a week and half. I recently visited a psychiatrist to get documentation to support the existence of emotional problems. She thinks I have major depression with anxiety and wants me to take the MMPI-II and begin psychotherapeutic work.
Oh. I was also referred to a VA research group.
Part of my problem is that some of the paperwork is inconsistent. One doctor states this or that about me and my condition, and another doctor states something else. My internist and psychiatrist attest to serious effect on my daily life, while the memory disorder clinic's neurologist states otherwise, though notes the short-term memory, etc.
Also, while I have many symptoms with decent documentation, the results on the physical signs are negative or inconclusive (which contributed to the initial VA rating), other than the diabetes insipidus stuff and some results from a PET scan reporting decreased uptake in the cerebellum and thalmi (which I have no clue what it means). But all the doctors acknowledge that there is something going on that they cannot completely figure out. Read: I have no actual brain lesion.
I also have the real problem that I am attractive, fit, very articulate, employed (though this requires a lot of additional work - mnemonic devices, extreme difficulties with coworkers and consequential lower performance ratings), and have graduate education. I think this will potential hamper my claim despite the documentation that I have collected. And you know what, I am very fortunate compared to many folks, but my level of intellectual functioning has decreased (>99th to 91st) and most probably will continue to decrease, not to mention that my working memory is currently around the 50th percentile, which is far removed from where I should be given my intellectual functioning. So, I still function far better than the majority of healthy folks, but it is a real decline for me darnnit! and frustrates me to no end because I find that I am unable to perform or remember the way I once was.
I don't really know how to proceed in regard to completing my file for a claim. I requested and received miltary and personnel records via the Privacy Act. I am doing my best to collect more documentation for the emotional component of this claim, but am virtually clueless how to proceed.
Please help. Advice? Thoughts?
Border
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