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.