Friday, March 7, 2014

Pain Management? (Red Tape Diary Entry #2)

Pain Management is one of the hardest parts of this journey. Some days I can even feel Chaz's pain because it gets that bad. His pain is primarily in his back, but he has occasional phantom pains in his legs.

Walter Reed did an excellent job helping us control his pain while we were there. We had to retire and leave that comfort zone. Since Chaz retired back to Tennessee we have been back through the gauntlet of suggestions of how to control his pain. And everyone wants him on pills. That seems to be everyone's solution....let's just throw a pill at it.

Pills are not an option for us. Chaz doesn't want to be dependent on pills. He does not want to raise our girls in a narcotic based home. He wants to get to the actual causes of his pain like we did at Walter Reed, but we have had a horrible time finding someone to listen to him.

At Walter Reed, pain management was a team based approach. It was Chaz focused, but I was on the team with the doctors and nurses. We all worked together to help Chaz cope without the pills. We discovered a steroid shot in his SI joint provided him the most relief and was the least invasive. He had his last shot just before he retired. 

Immediately after retiring we got him into the VA to get a pain management treatment plan started. Of course rather than listening to him or looking at his paperwork, we had to go through all of the steps we had already done at Walter Reed. He did the X-rays, blood work, TENS system, pain patches, blah, blah, blah. Guess what those didn't work and VA informs us that they will get us into their pain management and we'll go from there.

We finally got Chaz into the VA's Pain Management group only to wait. We finally received a call in August or September letting us know they couldn't see him until February. We were originally ok with this until we found out it was February 2015. Chaz primary care team got on it and got him into the fee base system for treatment.

Chaz finally got in for an appointment right around Christmas. He was so excited. The doctor came highly recommended. Chaz really thought he was going to get relief. Then boom here are some pills. Chaz tells him he doesn't want pills, he wants relief. Then he proceeds to tell Chaz what all he has to do to get another option. (I swear to you, this doctor never read Chaz's file.) So we take Chaz to get the blood work done, only to find out a week later the office ordered the wrong blood work and he has to do it again. Then he has more X-rays done and another MRI. We finally get through all of the hopes and get the procedure set up.

I am going to advise you to take a very deep breathe before reading the next few paragraphs....

We got a phone call yesterday telling us they were cancelling tomorrow's procedure because the VA did not fax back some paperwork that they sent over on 2/27. No, they did not ask if we could call about the paperwork. No, Chaz was not given any other options. The doctor's office just decided to cancel the procedure end of story.

Oh yes, Chaz was upset. Oh yes, I was livid. And oh yes the serial killer voice came out. I called that office right back was greeted with a young woman who told me that was their policy. I told her I had no desire to speak with her and wanted someone who actually could talk policy with me. We'll call the policy lady Sally. Sally will never forget my name, I can assure you of that. (Y'all should pray for Sally right now. Trust me she needed a drink after dealing with me.)

Sally and I chatted, of course we were both on the defensive, so the beginning of the call did not go so well. I am too stubborn to give up when it involves Chaz and the girls. There's this magic dose of "Oh Hell no," that sparks and you do not want to be around me. Sally informed me of their policies. I told her that at this moment her policies are irrelevant to me. I informed her I was pretty sure she was breaking some type of agreement or policy with American Medical Association. I told her I didn't know what it was, but I would find out and I would file a grievance immediately. And I asked when was it ok to have a 12 year old call and do her dirty work. (That is seriously how old the lady sounded. She was the one who told Chaz the procedure was cancelled without any additional answers. She is basically their receptionist.) She told me she understood why I was upset. She knew it was hard watching your loved one in pain. Then she informed me that she had over 30 years experience with the military, I asked about her experience with the VA, turns out she doesn't have much experience with them at all. I believe she said Chaz was their second case. It was a low number like that.

Then I asked her "Isn't pain management about team work?" She of course says yes. I asked, "Well when did we start leaving the patient off the team?" There was silence. I also informed her that not many people have been injured worse than Chaz and survived. And because of this categorization we have leverage at the VA and can help her with paperwork and such, but her team never gave our team a chance. I asked her if she ever thought about calling us and looping us into what they needed so we could help them treat Chaz. Again we had silence.

I told her that I was calling because Chaz was getting that procedure done tomorrow come Hell or high water. I told her I was calling because rather than dropping him like a hassle we were going to work together and get this done. Then I asked her what do you need? I wrote it down. Chaz called his nurse case manager and we put her on the case. Turns out Sally faxed the form to the wrong place. (I think you kind of need to fax it to the right place in order to get a response.) Turns out our AW2 rep and case manager have an "Oh Hell no" side as well. And together we got it all worked out in a matter of hours and Chaz will have the procedure at 12 today.

We will see how today goes and then we will decide if we continue with this group or do we begin the process all over again with another group. Something tells me people will be very nice to Chaz and I. Something tells me my little chat about team work did some good. I can only hope that my little chat not only helps Chaz, but makes Sally and her co-workers stop and think about being team players rather than policy holders. Policies are not laws. The can be adjusted and adapted with ease. I really think Sally and her team will start looking at the human side of policies. I can guarantee you they will when it involves our veterans who are in pain.


  1. So sorry about the above issue - shouldn't happen! Period. Can't Walter Reed recommend doctors/medical practitioners once you leave their facility?
    Way ta' go you .... you are such a fighter for your family. Sending you a hug and praying for your whole family.

  2. Praying so very hard that everything went well yesterday and that Chaz has finally gotten some relief!!!!!!!!!!!!!
    Psalms 86:5-7 For thou, Lord, art good, and ready to forgive; and plenteous in mercy unto all them that call upon thee. Give ear, O LORD, unto my prayer; and attend to the voice of my supplications. In the day of my trouble I will call upon thee: for thou wilt answer me.

  3. Hi - I have been "stalking" your blog occasionally and enjoy reading it (found it through a friend - while my H isn't military, he is a recent t/3 para.) I just wanted to say thanks. I am going to remember that "policies aren't laws". Policy has become a swear word in our house and I think you just gave me a new mantra!

  4. Always praying!
    Psalms 86:15-16 But thou, O Lord, art a God full of compassion, and gracious, longsuffering, and plenteous in mercy and truth. O turn unto me, and have mercy upon me; give thy strength unto thy servant, and save the son of thine handmaid.

  5. Praying right now!
    Psalms 17:6-7 I have called upon thee, for thou wilt hear me, O God: incline thine ear unto me, and hear my speech. Shew thy marvellous lovingkindness, O thou that savest by thy right hand them which put their trust in thee from those that rise up against them.

  6. Keep your eyes on the Lord! Praying!
    Psalms 62:1-2 Truly my soul waiteth upon God: from him cometh my salvation. He only is my rock and my salvation; he is my defence; I shall not be greatly moved.

  7. These words are so amazing and comforting!! Praying!
    Psalms 62:5-8 My soul, wait thou only upon God; for my expectation is from him. He only is my rock and my salvation: he is my defence; I shall not be moved. In God is my salvation and my glory: the rock of my strength, and my refuge, is in God. Trust in him at all times; ye people, pour out your heart before him: God is a refuge for us. Selah.

  8. Know that you're in my prayers!
    Psalms 61:1-4 Hear my cry, O God; attend unto my prayer. From the end of the earth will I cry unto thee, when my heart is overwhelmed: lead me to the rock that is higher than I. For thou hast been a shelter for me, and a strong tower from the enemy. I will abide in thy tabernacle for ever: I will trust in the covert of thy wings. Selah.

  9. it is nice to read al the information you've shared..thanks a lot

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  10. Lifting up prayers right now.
    Psalms 70:1, 4-5 Make haste, O God, to deliver me; make haste to help me, O LORD. (4-5) Let all those that seek thee rejoice and be glad in thee: and let such as love thy salvation say continually, Let God be magnified. But I am poor and needy: make haste unto me, O God: thou art my help and my deliverer; O LORD, make no tarrying.

  11. Praying!
    Psalms 69:1-3, 13 Save me, O God; for the waters are come in unto my soul. I sink in deep mire, where there is no standing: I am come into deep waters, where the floods overflow me. I am weary of my crying: my throat is dried: mine eyes fail while I wait for my God...But as for me, my prayer is unto thee, O LORD, in an acceptable time: O God, in the multitude of thy mercy hear me, in the truth of thy salvation.
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  12. Pour out your heart to the Lord! He hears! Lifting you up in prayer!
    Psalms 42:1-5 As the hart panteth after the water brooks, so panteth my soul after thee, O God. My soul thirsteth for God, for the living God: when shall I come and appear before God? My tears have been my meat day and night, while they continually say unto me, Where is thy God? When I remember these things, I pour out my soul in me: for I had gone with the multitude, I went with them to the house of God, with the voice of joy and praise, with a multitude that kept holyday. Why art thou cast down, O my soul? and why art thou disquieted in me? hope thou in God: for I shall yet praise him for the help of his countenance.

  13. Praying as always!
    Psalms 142:1-3a I cried unto the LORD with my voice; with my voice unto the LORD did I make my supplication. I poured out my complaint before him; I shewed before him my trouble. When my spirit was overwhelmed within me, then thou knewest my path.

  14. Praying right now!
    1 Peter 1:3-5 Blessed be the God and Father of our Lord Jesus Christ, which according to his abundant mercy hath begotten us again unto a lively hope by the resurrection of Jesus Christ from the dead, To an inheritance incorruptible, and undefiled, and that fadeth not away, reserved in heaven for you, Who are kept by the power of God through faith unto salvation ready to be revealed in the last time.

  15. Such words of comfort! Continuing to pray!
    1 Peter 1:18-19, 20 Forasmuch as ye know that ye were not redeemed with corruptible things, as silver and gold, from your vain conversation received by tradition from your fathers; But with the precious blood of Christ, as of a lamb without blemish and without spot (21) Who by him do believe in God, that raised him up from the dead, and gave him glory; that your faith and hope might be in God.

  16. Know that you're always in my prayers!!!!!!!
    John 14:1-3 Let not your heart be troubled: ye believe in God, believe also in me. In my Father's house are many mansions: if it were not so, I would have told you. I go to prepare a place for you. And if I go and prepare a place for you, I will come again, and receive you unto myself; that where I am, there ye may be also.

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