The Broken Soldier

I got an email from Vicky Ferriell at Fort Knox this morning.  She’s my case manager.  In an earlier email from COL Roger Soldano, a response to my wife asking for help and clarification of what paperwork we’ve not satified (a question for which we didn’t receive an answer, by the way), we were instructed to direct our questions about medical care to Ms. Ferriell.

This morning Ms. Ferriell directed me to address my needs for medical care to SFC Patricia Weir, a person who has known of my need for prescription coverage for almost a year, and COL Roger Soldano, who has known about my need for prescription coverage for several months.

I was in Fentanyl withdrawal for two days because these people, my “superiors,” have been unable to fix this problem for almost a year.  I’ve had an approved Line of Duty investigation for over seven months, and my wife and I are still paying between $300 and $400 a month for treatments.  And the people in the Army and the Guard simply don’t care.  Especially not about the plight of one unafraid to criticize where criticism is due.

The excuse we hear over and over and over again is that the Army and Guard have “other” soldiers to care for.  I wonder if those other soldiers are given that same excuse or just my wife and me.  In any event, it doesn’t fly.  But what it does do is support the idea that these people can’t do their jobs and don’t care about the impact their incompetence and lack of care have on those in their charge.

Addendum: I just received a message from Ms. Ferriell claiming that because I do not have the same TriCare that active duty folks have I have no prescription coverage.  Ms. Ferriell said something about SFC Weir getting back to me on this.  Not sure why that’d be necessary.  If I’m not covered, I’m not covered.  Though that I don’t have prescription coverage for a line of duty injury, if in fact that is true, is a bit distressing.

I was finally feeling better.  I had been in withdrawal for the a couple days this last week.  Neither the Army or the Guard have bothered themselves to answer my many requests for prescription coverage for pain medication I’ve made in the past seven months I’ve had an approved LOD, and my wife and I couldn’t afford them until yesterday.  Plied with a good dosage of opioid, I was feeling more like myself (a sad commentary of what my life has become).  With the tremors, cold sweats, headaches, hallucinations, nausea and vomitting gone I felt well enough to resume attending to business.

I had a meeting with an attorney yesterday.  A member of the National Lawyers Guild.  As I described the events that led me to where and who I am now his eyes bugged and jaw was dropped.  As is standard, I even gave the Army and the Guard the most charitable rendering of their position: I’ve not been given medical care or other entitlements for this line of duty injury because I’ve not been cooperative in satisfying paperwork requirements.  The lawyer wasn’t buying it.  In his opinion (and mine), if the Army and Guard’s position were true, a soldier’s uncooperativeness and not filling out paperwork is not a good justification for crippling, drug-addicting, and financially-ruining said soldier.  He feels my case is compelling.  And once he gets copies of email conversations between the Guard and I, as well as medical records, letters from my doctor to the Guard and to Carl Levin’s office, and other support materials, I have a feeling he’ll find the case all the more compelling.

My friend Dave, my ride for the day, and I discussed the meeting on our drive back to my house.  Dave knows the situation well.  During the drive he made a really astute observation.  The Guard seems to have a suitable bureaucratic structure (Dave, as a mathematical logician is always talking about structure this, structure that) to accomplish its mission, but it would appear that every level of that structure is dysfunctional.  The only function it serves, it seems to Dave, is to do the bare minimum of what’s required by job title so as to cover one’s own ass.  I couldn’t have put it better myself.

Just got back from having an EMG.  For those of you who’ve not had one, boy let me tell ya it’s a treat.  You take off your clothes.  You get into one of those gowns where your ass hangs out the back.  Then the party really gets jumpin’.

Little patches are placed up and down your legs or arms or whatever.  I had my feet, legs, hips, butt, and lower back done. You’re given a series of progressively higher intensity shocks.  A little machine to which the shock device attaches monitors and records the results.

The technician takes these results back to the neurologist for review.  Then, if needed, the neurologist performs further testing.  She stuck pins into the major muscles of my feet, legs, hip, butt, and lower back and applied an electric shock.

I’m sure my detractors are saying, “Sure Jimison (yawn).  So what?”  If Army medicine hadn’t done its best to confuse my diagnosis and symptoms I’d probably be saying “So what?” too.  But it didn’t.

The results: When lying flat on my back I have a pinched L5 exiting nerve.  This accounts for the pain, sensory disturbances, and motor loss I experience all the time.  Upon hearing that I asked the doc, “So my symptoms match my diagnosis?”  “Yep, they exactly match your diagnosis.” she said.  “Are these symptoms apt to get worse with activities such as sitting, standing, walking, etc.?” I asked.  “Yes, most definitely.” she said.  We didn’t get into the other symptoms I have.  The discogram will take care of that.

What I’ve learned from this, aside from what it feels like to have electrified pins jammed in my muscles, is depressed nerves and the symptoms they cause and the EMGs that reveal the physical component of both of those things don’t lie.  But retired Army doctors sure as shit do.  Especially when a retired Army doc believes he’s found a soldier he can push around.  The results of the EMG, along with a list of citations contradicting his confused position, are being sent to the nice people at ICE who followed up with me on the complaint I leveled at Dr. Toon.  Oh to be a fly on the wall in that meeting.

(Addendum: The lowest normal result for an EMG is 40 m/s.  I assume that refers to conduction velocity but I’m not sure of that.  Mine was 22 m/s.  Almost half of the lowest normal result.  The doctor said there is no evidence the neuropathy is progressing in my leg, but after a year of untreated nerve compression she didn’t appear to be hopeful for a recovery.  My right leg is Army Strong.)

Last week I received an email from someone near the top of the MI Guard totem pole.  A response to my begging for medical care.  In it the same distortions and exaggerations and threats and provocations and everything else I’ve come to expect from those who ‘go above and beyond’ for me.  The usual fare punctuated with some sort of washing their hands of me.  At first I was angry.  In anger I began writing a nasty letter of response restating for ten thousandth time the obscenity of all of this.  But after discussing the matter with my wife, my anchor and truly my better half, I decided against it.  Why give my opponent ammunition when he’s running out?

I was upset for a few days afterwards.  I really couldn’t believe what I was reading.  On the heels of receiving that email I got another nonsense filled email.  This one from some coward who seemed to confuse anonymously insulting me and those with whom I associate from a fake email address with putting forth a compelling counterargument.  I actually did write about it here, but later deleted the post.  If after the numerous links to the stories of other soldiers in similar situations one isn’t convinced there really is a problem, and that problem isn’t just me, the result of my failings, or my creation, I’m not sure how to reach that sort of person.  I’m not sure I need to reach that sort of person.

I was still pretty angry.  I was hating the MIARNG, and ruing the day I joined it.  But then it occurred to me that this email may be a blessing in disguise.  God does work in mysterious ways.  By washing its hands of me, and leaving my wife, my doctors and I to our own devices, as it were, in seeking medical care they’ve actually done me a great favor.  They’ve removed several layers of unhelpful, unconcerned, ineffective, and progressively more belligerent layers of impenetrable bureaucracy standing in the way of me and the medical care I need.  The rest of the stuff, incap pay, VA compensation, etc., I really don’t care about relative to possibly restoring my health.  Perhaps thanks are in order.  Thank you for getting out of my way.

I had my neurosurgery consultation today. I need surgery. The doctor and his staff think neurosurgery can decrease pain, but aren’t sure if anything can be done about my neurological symptoms. Given the length of time I’ve had this injury, the nature of the symptoms I have, and that in the last year I’ve received little treatment (and treatments I have received weren’t rendered in a timely fashion) the deck is stacked against me.

Today I learned, contrary to what’s written on the referral from Fort Knox and our reading of the authorizations for medical care we received, neurosurgery still isn’t authorized. I was informed that if I choose to go ahead with the surgery prior to receiving pre-authorization I will be responsible for shouldering the costs.

Time is an important factor in my recovery and in arresting further deterioration and onset of secondary illnesses and injuries associated with lumbar degenerative disc disease. The difficulty I’ve experienced penetrating this bureaucracy to get the care and benefits I’m entitled under the law has been made more difficult and more time-consuming by the efforts of a quack former Army doctor at Knox - a doctor the Guard promised me would be removed - confusing my injury and associated symptoms using methods and offering opinions that contradict uncontroversial facts of contemporary medical science. Yet the Guard and the Army believe the decision to move forward should be left ultimately to this doctor.

So I can wait for this tiger to change his stripes, or I can shoulder the costs of surgery and post-op care myself. Those are the choices I’ve been given. But those aren’t the only choices available to me. Archbishop Simpson returns on March 28th. On March 29th we will be filing writ of mandamus in federal court unless authorization is given or at least in the pipe. I think that’s reasonable. In fact, I’m sort of proud of the restraint I’ve shown. But like anything in the universe, my restraint has a finite supply.

I try to keep my posting restricted to once a day, if that. But there are times, like tonight, when I see something I just have to write about and share with my readers.

I found the following stories:

http://www.npr.org/templates/story/story.php?storyId=18492376

and

http://www.npr.org/templates/story/story.php?storyId=18742202

These are stories of an Army Colonel giving instruction to discontinue helping soldiers entering MEB/PEB with paperwork, and instruction to stop providing soldiers with explanations of DoD and VA disability ratings for their specific injuries. Why you may ask? Because, “there exists a conflict of interest.” This is in writing, in a memo you can find and read for yourself in the second link.

I have suggested this from the pattern I’ve observed, based on what I know of Army culture for some time now. But I could never tell you of their motives better than they could.

I see stories like these everyday. These in addition to my own experiences and those brave enough to share theirs with me. A recruiter isn’t going to tell you young bucks and does this. The Army surely isn’t going to release this for ‘wide-release.’ This, my friends, is why I do this. Because they won’t. They don’t care about you. I do.

I got a return receipt first-class letter from the Guard today. It was the neurosurgeon consult we already got. Your tax dollars hard at work.

I’m betting the return receipt and confirmation doubles as an ass-covering device of sorts. I’m confused why else they’d go that extra mile. I’ve never complained about not receiving authorizations when they’re approved. Strike that, I complained once: When the approval for physical therapy sat for a month before Sheila Marolla in Levin’s office told me about it. I’ve complained about not getting authorization for certain care, and authorizations that are too vague about what care is covered to be very helpful.

Yesterday I got a notice from my bank of a deposit. Those are always nice. I assumed it was from the Army. I’ve been expecting some reimbursement for the expenses incurred traveling to Fort Knox, KY for an unusable MRI, as well as two days of active pay for the same. Instead the Army deposited $5.95 in my account.

“Why are you complaining young man?” is a question you may be asking yourself. Well, I’m complaining because my wife and I spent close to $500 of our own money up front to make that useless and unnecessary appointment. Because of that, and because we’re living on one income and have not received additional months of incapacitation pay, my wife and I are put in the unenviable position of choosing between making our mortgage payment and paying for my pain and depression medications.

Run right out to your local recruiter kids. This too can be yours.

Finally we received authorization for consultation with a neurosurgeon. We’re still confused about what is actually covered, just the doctor’s visit or the procedures he prescribes, but Sarah and I are happy that I’ll be seeing a neurosurgeon soon.

But this victory, from experience I’ve learned getting the Army to do what it is supposed to do is a ‘victory,’ may be tainted. There is still confusion, possibly feigned, surrounding this matter. Let me explain.

As I wrote in a post just after Sarah and I returned from Fort Knox the last time, you remember, the trip for the MRI?, the MRI technicians both claimed the MRI generated was unusable. This was because my back and legs were spasming uncontrollably as a result of aggravating my injuries with a 9-10 hour car ride from Michigan to Fort Knox, KY. As such, the image would be too blurry to show what was really going on. But Dr. Toon, a man whose performance has inspired at least a few other posts here, wrote in his report that my lumbar spine is ‘normal’ according to the MRI. What????! How can an unusable MRI help one conclude anything about the nature of the body part viewed? Answer: It can’t.

As well, in Dr. Toon’s first report he wrote, consistent with my other health care providers, that the first MRI showed degenerative disc disease (DDD). Signs of DDD show up as areas of black on the affected disc on MRIs. While there are treatments for the symptoms of DDD, the disease itself is not treatable let alone reversible. To miraculously get a ‘normal’ read on an MRI is not only a contradiction of conventional medical science, it’s also a contradiction of his own previous opinion.

This message is a call to get other soldiers, airmen, seamen, and marines harmed by military medicine and or military bureaucratic roadblocks to pay and benefits on board for a press conference. Details of where and when will be ironed out as soon as we have an idea of who’s involved and their level of commitment.

For those uncomfortable speaking to press, you can still help. The Archbishop is willing to speak on our behalf. We would serve as backdrop unless we wanted to do more.

We have commitments from injured service members already. Some I’ve talked to seem to believe speaking out against this is or could be construed as anti-military. Making a problem the military has with keeping its promises to those who’ve enlisted known to those outside the military when those in it have failed to address these matters is hardly anti-military. If anything, better access to medical care, pay and benefits is the most pro-military, pro-service member stance one could take. For those who would construe or claim to construe shedding light on these problems, problems that destroy the lives of service members and their families, as anti-military I suggest their opinions aren’t driven by a desire to force the government to keep its promises to us, and certainly not by a desire to do what is in our best interest. They’re likely the kind to push ‘mission first’ down your throat, themselves never having suffered the harm we have. In other words, their opinions don’t matter.

Until we speak out nothing will change. My friends, courage and integrity and strength aren’t measured in one’s ability to endure injustice, contrary to what you’ve been told. Courage and integrity and strength is hating and fighting against that which is clearly wrong.

Addendum: Do not be afraid, as I was in the beginning, of aligning yourself with someone or some group who may otherwise not be like you. Agreement on every issue is not possible and isn’t necessary. If you can find those with different political views who agree and are willing to support you on this issue, accept their agreement and offers to help graciously. I am finding a lot of my support is coming from members of left-of-center religious groups. Left-of-center certainly doesn’t describe me. But so what? We agree that active and reserve component military members deserve to receive medical care and benefits consistent with the law. When they don’t receive these things, a great injustice has occurred. You don’t need to agree on everything else to agree and accept help on this.

I’m not well, and I’m afraid I may be on the downward slide. Usually my injury and my symptoms are made worse by doing stuff - sitting up, standing, walking, etc. Yesterday was a typical Sunday for my family and I. We sat around watching TV, playing board games, video games, doing crafts, and otherwise enjoying each others company. I can’t sit for more than 20 minutes without laying down for an hour or so to recover. Yesterday I was laying down for a couple hours, and the pain of sitting up for less than half an hour just wouldn’t go away. I wound up staying in bed laying flat on my back all day.

The pain was pretty intense. Maybe a 6 or 7 on a 10 point scale. Just from sitting up for a little while. Crazy. But I can live with pain. Well, sort of. What I can’t live with is the humiliation that comes with an injury of this sort. 20 minutes of sitting up caused me to lose control of my bowels. I can’t think of anything more humiliating than that.  This isn’t the first time this has happened, but it is the first time it’s happened with very little activity.  I was once a very strong man.  Now I mess myself like a baby.  I hate that this is what my life is going to be like.  And I hate the Army and the Guard because had they done the right thing at any point in this story this could have been avoided.

And the Army and the Guard still haven’t approved the medical care I need. Just in case you were wondering.