Monday, November 16, 2009

VA SAN ANTONIO DECLARES WAR ON VALLEY VETERANS

On my situation I am still waiting on the test results. A female doctor who identified herself as the head of endocrinology at the medical school called me late Friday afternoon. What happened supports my position that the worse thing veterans can do for themselves is demand a hospital in the Valley. So long as the medical school has anything to do with veteran’s care the care will be substandard. For those who may not know, the doctors at the medical school have privileges at both University hospital and the VA San Antonio. They run the clinics in both hospitals.

I will get to it, it is about money and she said it as plain as day. After she lied to me 3 times. One, no one has done an MRI on you. Lie - bold face lie. I explained to her I was holding the MRI summary in my hands. She then said there was nothing in the written report about my pituitary gland. I said, did you look where it says incidental findings? She finally then conceded there is an MRI report with an incidental finding about my pituitary gland.

Lie two: There has been no referral by your primary care doctor to endocrinology. I forced her hand to review my records and she had to concede there was a referral. Then she said the doctors had not acted on it yet. She knew this was a half truth. In her clinic she has a PA making decisions. This is a key problem with the VA, PA’s, Residents, and Fellows are running the show. The doctors are no where to be found, in most cases.

So we went a couple of rounds and she finally conceded that her PA had ordered all of the blood work and urine tests. We do not have the results yet. My urgency in this is, I am losing my vision. If I do not eat nearly non-stop I have mind numbing headaches, incredible eye pressure, extreme fatigue, and extremely blurred vision. To get in the car and go to Walmart I have to stuff myself to the point it hurts. I will then have an hour to get around without blurred vision.

I will finish the story but here is the money side. At the point I called her to the mat over lying 3 times, or showing a complete and total lack of interest in the evidence, she says that I have to understand that the new system in the Valley has caused the VA San Antonio to loose a ton of money in its budget. She said that Valley veterans are not being handled with a priority in SA because of a reduction on SA’s budget to support the new system in the Valley.

Under the new system, the veteran has the choice of being referred locally or to go to SA. Because this matter has been handled already in part in SA it is best I continue through SA. Part of the problem is, which the VA has yet to work on, doctors outside the VA system cannot access your medical records. Further, they cannot access the MRI pictures. They have learned that putting the MRI on a disk for the outside doctor to review does not work either. It loses enough resolution that it makes it dangerous for a doctor to rely on the pictures. This is why it is important for a doctor with access to my records be assigned to my case.

So now you have it, because of the anger over losing money in their budget to fund the new system in South Texas, VA San Antonio is putting Valley veterans on the back burner. This is the second time this has happened to me since the new system came into place. When my primary care doctor sent me to neurology in SA over my back problems, they dismissed the referral. Weeks later when the Chief of Staff investigated the matter all of a sudden a Fellow (specialist in training) referred me back to my primary care physician telling her to send me to a local neurologist. Dr. Bauer (Chief of Staff) reviewed the MRI and this is how I ended up in pain management with Dr. Hays. Dr. Hays is the one who did the procedure which relieved all of the burning pain in my legs and hip.

How did I end up talking with the head of endocrinology? I got tired of no one in endocrinology returning my calls. The system provides for the clerks to leave a message with the PA. She does not accept nor returns call. I then went to the new interim Chief of Staff whose staff told me that because he is interim, he is not getting involved. I was assigned to a patient advocate by the name of Mary Scott. Ms. Scott neither accepts nor returns phone calls. A Rachael in the Chief of Staff Office literally told me after I informed her Ms. Scott was not communicating with me that she would have Ms. Scott call me immediately. Nothing - absolutely nothing. I called back that afternoon, and I was told someone else would call me. This is when a David called me. He did force endocrinology to look at the referral. This is how the blood and urine tests got ordered. After that I could not get David to accept or return my phone calls.

A Carolyn in the Chief of Staff Office told me I was lying when I told her the history of not being able to speak with Mary Scott. I told her I have my phone bill which records all calls. She insisted I was not telling the truth. I became rude with her, which was wrong, and she hung up. Anyone who works at the VA who believes it is okay to call the veteran a liar has no business working at the VA.

People need to understand over the last three weeks I have gone from being able to type and see my computer screen without my glasses, to now having to put my face up against the screen to be able to see what I am typing. When I was talking to Carolyn I had a mind numbing headache, I was falling asleep, and I could not see my hand written notes. I tried eating something but my belly was so full I could not get anything else down. I cannot take my blood pressure medicine because it totally kills my appetite (which is a good thing, but not now.) Hypoglycemia (assuming I am having a hypoglycemic problem) is not always linked to diabetes. See these notes. http://www.mayoclinic.com/health/hypoglycemia/DS00198/DSECTION=causes

I want to make something clear. The problem is not with the Harlingen clinic. I have the best doctor any patient could ask for. The problem is you have experienced clinicians in Harlingen dealing with doctors in training in San Antonio, or physician assistants. The university specialists who oversee VA speciality clinics are too arrogant and important to get involved. I truly feel sorry for our doctors in Harlingen. The system works and works well, until they have to interact with San Antonio. We have good doctors who end up giving up because they know San Antonio is a nightmare, with rare exception.

I am clueless about these veterans who want to bring this system of doctors in training to treat veterans. They are so obsessed with the concept of a hospital that they seem to not care about the only issue which matters, quality of care.

Some additional background so you can understand that in Harlingen we have a great team of doctors. My doctor had the courage to reject the medical advice of a VA SA cardiologist when it was clear to her he had never reviewed my records, or if he did he committed extreme malpractice by prescribing a medication which my records clearly indicate I cannot take. The pharmacist never would have given me the prescription because the system would have blocked it.

The then Chief of Staff Dr. Bauer reviewed everything and ordered the Chief of Cardiology to see me. Dr. Moody refused the order of Dr. Bauer. When I got to the clinic I was told that I had to be seen by a Fellow Cardiologist (Cardiologist in training). I asked to see the attending cardiologist and was told the Fellows run the clinic and no licensed cardiologist was at the clinic. This is what the stupid veterans are demanding for South Texas .

When I said I was going to Dr. Bauer’s office I was told to wait. About an hour later Dr. Moody saw fit to leave his office at University Hospital and walk across the street to see me. Without reviewing my records or even talking to me he demanded to know how often I was doing cocaine and or marijuana. I filed a complaint with Dr. Bauer.

It is the absolute right of the veteran to be seen by a licenced general practitioner or specialist. In the case of speciality care, what is the point of specialty care if you are only going to be seen by a PA or doctor in training. I can tell you, if you demand to see the actual specialist, in nearly every case there will be retaliation. They do not want to leave their offices at the university, except on pay day- then they can find their way to the VA.

I have no idea why Dr. Bauer left his job as Chief of Staff. But this became a bad day for all veterans. At least when he was there we had and advocate, now we have nothing. I will tell you, Dr. Wellington (Chief of Staff) in Harlingen is also a great patient advocate. He has done an amazing job with hiring great doctors. The problems we have in Harlingen are all administrative. Things on that note seem to be getting better all of the time. The VA is working hard to hire a lot of specialist for the VA Harlingen clinic. I just hope these veterans demanding a teaching hospital will not screw it up with their obsession for form over substance.

16 comments:

Anonymous said...

So how did you end up talking to the head? Getting no phone calls returned to getting a phone call returned is not clear.

With your state of health being so dire, how are you able to type so well? I didn't see one typo in your whole post. That's got to show some improvement, right?

Anonymous said...

Are you having hot flashes?

BobbyWC said...

I have been having hot and cold flashes for years. There are times when I should be hot and I have to wrap my legs in several towels because they feel like they are in ice. Other times my friends will ask me to either turn up the heat or turn down the air because I am like on fire.

As to the phone call.

On Friday I got to thinking and called Univerity hospital - it was not easy - I had to call to the Chief Medical Officers office before I even got to the secretary for indocrinology. I left the message with her and that I had filed a complain in Washington, and about a half hour later the Chief of Indo called me.

And for the record I am not feeling better. There was nothing I could do to control the headaches today. I just got up from a 4 1/2 sleep.

Bobby WC

Anonymous said...

About three weeks ago, you were very positive about doctors finding the problem in your pituitary gland. I can't help but think this is your mind playing tricks on your body. Don't let that happen. You remind me of Frodo in Lord of the Rings who almost succumbs to exhaustion before completing his task. You must fight on.

Think positive. Sleep makes us look younger. It is endocrinology with an e. You left off the t in complaint. I guess you are feeling worse. Are you taking any new medicine that might be contributing to your sudden turn for the worse? One more thing, when was the last time you went out for a drive and enjoyed the weather?

Anonymous said...

You are barking up the wrong tree with your pituitary gland being the source of the problem. In light of the wild temperature fluctuations the guy talking about the hypothalamus may be right. The pituitary doesn't do a gosh darn thing to your body temperature. What kind of doctors are you seeing? No wonder you sue everybody. I would too in your circumstance.

BobbyWC said...

I can tell you right now, I am pooring sweat, but mny temperature is 96.4.

Thanks for noticing my typing is not perfect. This morning's post was started on Saturday, worked on on Sunday and finished this morning. Last Friday it took me 8 hours to do what should have taken an hour. It is slow.

As to hypothalmus. This too interacts with the pituitary gland. It is not that the pituitary gland is the problem per se, it is that it is causing something else to not work properly (maybe).

The problem with the VA is they cannot allow a patient to be seen by a specialist without a referral. Once the referral is done the world stands still until the specialist acts. In SA, more so than any other VA I have ever used, if you are not your own advocate, nothing ever gets done - ever.

I was told today the Chief patient Advocate in Washington would have someone get back with me today. It is now 5:31 - noting - absolutely nothing.

It is the same old bullshit - he sent an e-mail to someone and they ignored it. He got busy with something else and dropped the ball.

My general practitioner cannot refer me to anyone else until endocrinology acts.

For 10 years I was passed around over the issues with my back. No matter how many times I complained I was refused access to a real specialist.

Only after I nearly drowned last summer was an MRI ordered - and there it was adhesions on L4-L5 - Dr. hays fixed the problem.

Bobby WC

Anonymous said...

I know you don't want to hear this, but it seems that Commissioner Melissa Zamora is doing her very best to stop public comment and free speech.

Under Item 12 of tomorrow's agenda, she has signed on with the mayor to place public comment prior to adjournment "where there would be less distraction". The Resolution was approved by John Chosy. Isn't he the one handling your lawsuit against the city? Oh and the City of Brownsville is going into the bus vendoring business with the City of Pine Bluff, Arkansas.

How can they with a straight face say they are interested in public comment but still want to place those comments where they would be less distracting? I hope your lawsuit is one of the items up for discussion in executive session.

A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF BROWNSVILLE, TEXAS DIRECTING PLACEMENT OF “PUBLIC COMMENT” PERIOD ON CITY COMMISSION AGENDA

Whereas, the City Commission of the City of Brownsville, Texas has always welcomed public comment on matters of interest at its meetings; and

Whereas, the attention paid to the public comments has sometimes been affected by the press of upcoming business; and

Whereas, the best way to resolve this potential problem is to place the public comments in a place on the agenda where there would be less distraction.

NOW, THEREFORE, BE IT RESOLVED that the “Public Comment” section of future meetings of this commission be placed on the agenda immediately preceding adjournment. Done on this the 17TH day of November 2009.

BobbyWC said...

It is there right, and the people's right to consider their acts when they go to the polls.

Troiani, Longoria, and Atkinson have the most to lose by voting for this - I will be shocked if Camarillo votes for it. Gowen seems to me has nothing to gain by voting for this.

We shall see what happens.


Bobby WC

Anonymous said...

You are very calm about this Bobby. Is it because you have been told they will consider your case finally? If they are all tyrants like you claim, then they will vote for this resolution. Legally speaking, can they create a resolution when it affecting an ordinance that was passed with a public hearing. In other words there is no public hearing for this change in the Agenda and Meetings section of the city code.

Melissa Zamora said...

I do not support moving public comment to the end of meetings. In fact, I've discussed with fellow commissioners, including the City Attorney, to move the item to the beginning of meetings.

I co-sponsored the item to allow the Mayor to present the item for discussion. And, I would co-sponsor other items I may not support to allow other commissioners the same courtesy.

Anonymous said...

Hope you get better soon.

Fred D said...

I am so sad at hearing about your health problems. I filed a claim some months back relative to a number of issues including type 2 diabetes which I now have under control with lost weight (120 lbs) and diet. I have been battling a number of problems that thankfully the health policy, I kept after retirement, was good I was able to see excellent people here starting with Dr. Pelly and including wound specialists in San Antonio. After 1 plus years I am nearly healed and am learning to walk again. If I had to depend on VA - I wonder.
I suspect that the VA experience is what Government administered health care would be like (ie Germany) when money runs out and the Chinese foreclose.
Keep up the fight and we can have another debate lunch.

BobbyWC said...

VA SA does not have doctors treating for lipid or diabetes - they have clinical pharmacists. I had one fired after she demanded in writing that I go back to a drug which caused me to have negative reaction. She also made some racist comments about Mexicans after I pointed out I would just buy my Zetia in Mexico.

I can tell you I hit a real bad nerve in SA - no one will talk with me - in the past their lawyers in Washington have told me that in Texas the VA's do not respond until sued in federal court in Washington. Even then it could take months while everyone plays the blame game.

they will not let me see a doctor or allow me to see the test results - I think they are afraid of being sued over failing to diagnose for 10 years and allowing me to get to this point.

People can say what they want about me but I always worked 60-80 hour weeks. It is very hard on me emotionally to not work at least 60 hour weeks. In law school I finished in 2 1/12 years while working at a law firm and teaching two courses a semester at Houston Cmmunity College.

Anyone who knows me knows I am addicted to work - not working is very bad for me mentally - it makes me feel useless - people have no idea how much I want to go back to at least 60 hour weeks.

Bobby WC

Fred Drew said...

I would like to apologize to Bobby. I used a part of his comment regarding applying for veterans Benefits in my column of 11/22. I originally had indicated its source as very popular local blog. I am not sure if I cut it inadvertently when I was preparing the article for sending or if it was done at the paper but it is still my responsibility. If Bobby prefers I would do what I can to publish an apology in my next column. I will also post this apology on my Web Site.
Again I apologize.
Fred Drew

Fred Drew said...

I had not read the actual article in the herald but found the primary source was mentioned in the first line. However it was still unclear so I would like to comment to my comment.

I used a part of a comment regarding applying for veterans Benefits in my column of 11/22. I indicated its source as a comment from another source an earlier comment in the Herald, in the first few lines of the article. I am not sure if I cut it inadvertently when I was preparing the article for sending or if it was done at the paper but it is still my responsibility for clarity. It may give the impression that the situation happened to me. As it happens commentary of a similar nature also appeared in one of the most popular local Blogs.

If the author prefers I would do what I can to publish an explanation in my next column. I will also post this apology on my Web Site.
Again I apologize.
I am reluctant to post names as it is personal.
It did not happen to me but I have filed for benefits some weeks ago with not even a receipt yet
I value my credibility and want to take any measures necessary for clarity.
Fred Drew

BobbyWC said...

Drew I am fine, nothing further is needed. If the Herald needs for me to sign some type release I certainly will.

The issue is always more important than the person behind the issue or idea.

Since I do not buy the Herald and its online edition is not yet available, could you please e-mail me a copy.

Again thanks for the heads up - but nothing further is required.

Bobby WC