PTSD: Post Traumatic Sarcasm Display

I went through another evaluation this week at the VA. The exams themselves are pretty stressful and could aid or assassinate your disability rating.My diagnosis is older than the cavalry and I figure that telling the truth gives me less to to remember and then stress over….The VA uses a Global Assessment of Functioning Scale (GAF) in part to determine your disability level. The real scale goes like this:

91 – 100
Person has no problems OR has superior functioning in several areas OR is admired and sought after by others due to positive qualities

81 – 90
Person has few or no symptoms. Good functioning in several areas. No more than “everyday” problems or concerns.
71 – 80
Person has symptoms/problems, but they are temporary, expectable reactions to stressors. There is no more than slight impairment in any area of psychological functioning.
61 – 70
Mild symptoms in one area OR difficulty in one of the following: social, occupational, or school functioning. BUT, the person is generally functioning pretty well and has some meaningful interpersonal relationships.
51 – 60
Moderate symptoms OR moderate difficulty in one of the following: social, occupational, or school functioning.
41 – 50
Serious symptoms OR serious impairment in one of the following: social, occupational, or school functioning.
31 – 40
Some impairment in reality testing OR impairment in speech and communication OR serious impairment in several of the following: occupational or school functioning, interpersonal relationships, judgment, thinking, or mood.
21 – 30
Presence of hallucinations or delusions which influence behavior OR serious impairment in ability to communicate with others OR serious impairment in judgment OR inability to function in almost all areas.
11 – 20
There is some danger of harm to self or others OR occasional failure to maintain personal hygiene OR the person is virtually unable to communicate with others due to being incoherent or mute.
1 – 10
Persistent danger of harming self or others OR persistent inability to maintain personal hygiene OR person has made a serious attempt at suicide.

I checked with several vets and found that GAF corresponds loosely to disability rating as follows:

1-20 = 100% or $2,527 a month and free medical care at the VA

30-50 = 50-70% or $356 to $1,161 a month and free medical care at the VA

60 might rate you at 30% if other factors are an issue. That would give you 30% disability and $356 a month and limited care at the VA

So, you can see that the VA leprechauns guard the golden gates of Brigadoon pretty well…

So, time for a little fun…

I stumbled across several spoofs of the GAF as it relates to the VA and I decided to modify one for you. It is not to make light of the disorder, but to spoof a broken system. Like my mom used to say: You have to laugh to keep from crying…

VA GAF

91 – 100 Not much happening and you can tolerate most stress very easily. Your spouse is away for a couple of days and you sneak your dog into the bedroom. One of your kids is wearing his pants below his underwear, but still talks about going to Brown University.

81 – 90 Some minor setbacks. You are late with your AT&T bill but, screw ’em, they have turned into a monopoly again anyway. You have spent $300 more in overages on hold with the VA about your claim. You think Siri is beginning to understand your needs. The dog has wet on the bedroom carpet, but it is dark enough she’ll never notice.

71 -80 AT&T is texting you. You dictate replies to them through Siri. The teachers strike has the kids at home 24/7 and you tell them that if you hear Gotye one more time they will just be somebody that you used to know.

61 – 70 AT&T has discontinued service. Your artillery ears can barely hear the high pitched ringtone on your Cricket phone. The dog has hemorrhoids and drags his butt all the time. The kids duct-taped the neighbor boy to a stolen shopping cart, pushed him into the forest preserve pond and uploaded their Jackass spoof to Youtube. The police are trying to call your old number. You miss Siri: You wanted to ask her why a boxing ring is square.

51 – 60 Your kids have decided to enlist in the military in lieu of jail time. You and the dog howl in harmony. You’d play drinking games if there was any booze left. Cooking distracts you from NCIS and just isn’t worth the effort. The VA has told Homeland Security about your threats.

41 – 50 Your wife has decided to move back in with her dysfunctional family. The VA Homeless program will not accept you as long as you have 3 more months before your bank actually evicts you. You think you can teach the dog to dance and audition for America’s Got Talent. The sun is getting noisier every morning.

31 – 40 The only thing that gets you off the couch is chest pains. You are sure the dog is talking to the cat about you. You asked the cute activist next door to occupy your underpants. The police have your new number.

21 – 30 You siphoned gas from the neighbor’s leaf blower and are going to fix this problem once and for all. The ungrateful dog criticizes you on Twitter and your Klout score hits an all time low.

11 – 20 They move you to a facility where the WWII vets keep trying to get you to surrender. The VA finally approved your claim, but appointed your ex-wife as custodian of your affairs. She promises to give you money for Bingo. You start a blog, because the voices in your head NEED TO BE HEARD. They don’t change your diapers nearly as often as before.

0 – 10 The nurses refuse to take you to the bathroom until you stop yelling, “FIRE IN THE HOLE” and your kids have no more room in their closets for your Afghans sweaters. Your VA claims adjudicator is promoted to regional director for his efficiency. You and reality dissolve your civil union.

Dog Them….

“As soon as one promises not to do something, it becomes the one thing above all others that one most wishes to do.”
― Georgette Heyer

The conventions for America’s two biggest political parties are over. Despite the fact that Honey Boo Boo and NFL Football brought in bigger audiences, tens of millions tuned in to cheer, jeer or better understand who to vote for in November. Both conventions made frequent reference to American veterans and spoke with passion about their care and concern for military families and especially for those injured in service to America. Despite all the bi-partisan passion and genuine intentions the VA is getting worse, not better, at handling the needs of veterans. Much needed transitional aids are mired down in bureaucracy or about to eliminated altogether by the VA. Intentions do not equal action.

This week, the VA announced in the Federal Register, via 60+ pages, that it will no longer cover the cost of service dogs assigned to people with post-traumatic stress disorder. The VA claims there is not enough evidence to support the medical need for these dogs.

“Although we do not disagree with some commenters’ subjective accounts that mental health service dogs have improved the quality of their lives, VA has not yet been able to determine that these dogs provide a medical benefit to veterans with mental illness,” the VA said. Anyone who has worked in the field knows this is a baseless assertion. The real reason for eliminating the dogs is likely financial.

The Federal Register estimated that only 100 dogs would be certified this year when every service dog group I contacted said that growing demand already outstrips available resources. Just at Ft. Carson’s Wounded Warrior Program, says Diane Vertec of Freedom Service Dogs, “The population is growing exponentially. We feel like a dog can help a vet meet physical challenges but, more importantly, can really, really help them overcome a lot of the mental instability that they’re feeling.” FSD trains about 40-45 dogs per year and there are about 450 soldiers in the Wounded Warrior Battalion at Fort Carson.

In the Stars and Stripes, Lindsey Stanek, the CEO of Paws and Stripes, a New Mexico-based nonprofit dedicated to providing service dogs for military veterans, said she finds the Federal Register’s conclusions “preposterous,” adding that the demand among veterans for service dogs far outweighs VA estimates. “We have a wait list that exceeds 600, and we’re just one organization.” The rules will stay in effect until the VA has a chance to study the efficacy of service dogs in PTSD. By then, after adding on the 12-18 months of waiting time for a trained dog, a vet might be 4-6 years into his disability.

I called the VA last week to get in under the wire and get Gander covered by the program. After unsuccessfully querying to seven departments at a local VA Hospital I phoned the national medical information help line at the VA. The VA suggested I call the hospital. I then contacted my PTSD doctor and scheduled and appointment. She has long supported my need for a dog and has seen it change other veteran’s lives. She placed an order for evaluation with the prosthetics department who then scheduled me to be evaluated by the physical therapy department. After my evaluation, in October, physical therapy will send my requirements for a dog to the prosthetics department who will then send it on to the VA in Washington, DC. The VA will decide whether or not I should have a dog. If approved, the prosthetics department will then “order” the dog I will already have by that time. This might all be moot anyway if the regulation goes into effect at the end of this month.

The VA does not pay for the dog, which Freedom Service Dogs spends $20-25,000 dollars to train. But, they will cover major medical issues for Gander. The hospital explains it like this: The dog is equipment and they don’t pay for routine maintenance, buy will repair “it” if it breaks. And if a vet’s heart is broken by the loss of his equipment?

So,there is no money. Veterans can train their own battle buddies, right? Not so. The VA also proposes to block non certified dogs admission to its facilities. Those dogs who have helped vets carry oxygen bottles, or detect seizures are equipment non-gratis in the hospital . No attempt was made by the legal beagles who drafted the document to provide for those veterans who depend on their companions and rarely leave home without them.

Illinois defines a Service Animal this way:
“The Americans with Disabilities Act (ADA) defines a service animal as any guide, signal dog, or other animal individually trained to provide assistance to a person with a disability. An animal fitting this description is considered a service animal under the ADA regardless of whether the animal is licensed or certified by state or local government.” There are stiff fines for refusing service to a disabled person with a service animal regardless of its certification. The VA sees it differently.

To make matters worse: The Tampa VA has been working with several Assistance Dogs of America certified trainers and providing some cash to agencies if they will participate in a multi-year study program. The VA has foisted several unrealistic expectations on trainers like requiring them to sign documents stating their dogs will not misbehave during their placements. Some trainers are considering opting out of the study because the VA has also tried to micromanage their programs.

Jonathan Swift said that promises and pie-crust are made to be broken. I say that if politicians push veterans out on the front lines of their re-election battles, the least they can do is turn intentions into fulfilled promises.
Help them here:
I have put up petition at Change.org Please sign

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You can read more about m journey to get a service dog here: http://veterantraveler.com/service-dog

Take a Gander…

“Dogs are minor angels…”

–Jonathan Carroll

It seems including a service dog in my logo wasn’t just wishful thinking: I was on my way home from watching Frank & Robot yesterday when I received a call from Freedom Service Dogs in Denver telling me I was soon to be blessed with a new traveling companion. It was a touch of synchronicity, because the film was, in part, about companionship and our dependence on others, no matter how tough or self reliant we imagine ourselves to be…

I have had a series of best friends of different breeds. My dogs and I have always viewed the world together with a slight turn of the head before heading off together to enjoy a quiet walk in the woods or a sunset over the lake. Dogs are charitable sidekicks: always seeming to know what not to say at just the right time.

This will be new for me. Unconditional love is part of a dog’s DNA, so I feel a little guilty about asking more of a friend who, even without training, will do more for me than I will ever do for him.

FSD tells me that Gander is the name of my PTSD savvy buddy-to-be. He is a chocolate, mixed breed who was rescued from a shelter before being enlisted in the service and trained by FSD’s extraordinary team of handlers.

FSD was founded in 1987 by P.J. and Michael Roche after a disabling car accident that personally informed them about the tremendous need for canine helpers. The program has strategic alliances with the VA, Denver University’s Institute for Human/Animal Connection and the Graduate School of Social Work and Assistance Dogs International a training standards organization.

I was in China and in the midst of my physical and PTSD symptoms worsening I found myself rescuing local strays and in doing so I noticed improvement in my affect and mobility. I had seen videos of pets being brought to nursing homes and prisons to combat depression, but I had no idea that it was a fast evolving treatment strategy in the U.S. for veterans. Soon after, I watched a video about FSD and began to explore the possibility of a service dog for myself. I was sure that a match for me would be life changing.

FSD answered my email the same day and I downloaded the application. FSD is appropriately cautious and very thorough. Each of the 35-40 dogs they train each year costs from $20-25,000 for its 9-12 months of specialized training and is then gifted, at no cost, to the veteran. Before receiving a dog, the recipient must meet eligibility requirements, wait 12-18 months for a match and then attend three weeks of training with handlers and the dog.

The professional staff considers themselves to be”dog people” first and foremost. That means each veteran sign contracts that call for high-level care of the service dog. FSD makes a lifetime training and care commitment to both the dog and his human.

The application process was a several week journey for me. I secured the required medical evaluation and certification from my VA doctor, finished my personal statement, and took it with me to FSD in Denver for the required face-to-face interview and matching procedure. For matching, the handlers brought in poodles, labs, and a gentle giant of a dog they appropriately called Zeus. They watched carefully to see how dogs and I got along. I not-so-secretly hoped for a black lab. But, one look at Gander’s intelligent, confident, scruffy face yesterday and I couldn’t remember why I wanted a different breed of dog.

I will be heading for Denver in September to meet and attend school with Gander. In the interim, he is being taught to to do specific tasks the team identified for me:

  • Retrieving items to my hand
  • Turning lights on when I enter my house
  • “Check it out” or “clear the room”: Having him check for anyone else that might be there.
  • Find the phone to retrieve it in an emergency situation.
  • Find a person when needed
  • Brace to get up: He will help me get back up if I fall. (When I first spoke to FSD I had real trouble with autoimmune arthritis issues. They are better now. )
  • Block/Post: He will stand in front or behind me to create “safe” space in public
  • Lean and interact: He will lean on me to keep me grounded and attending to what is around me. I hear he loves to lean in and kiss…
  • He will interact with me in ways that will help pull me out of night terrors or nightmares
  • He will heel very close to my right leg (it is usually the left) when I am walking so that he can help me walk across pedestrian bridges and stay more in the middle away from real or imagined danger
  • My life has already changed. I’m walking a little brisker and I’m attending to people with dogs the way an expectant father cops at infants in the supermarket. School in Colorado can’t get here fast enough. As Corey Ford said: “Properly trained, a man can be dog’s best friend.”
    My indiegogo campaign for Gander:
    http://indiegogo. com/veterantraveler

I will be telling you more about my minor angel in weeks to come. In the meantime, please follow FSD on Twitter: http://twitter.com/freedomsvcdogs and visit their service dog website to see how you might help.

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My PTSD (part 2)

Several people emailed and messaged me following my last post on PTSD. They thanked me for articulating their feelings. I am humbled by the number of people still unable to give voice to the dysfunction and depression in their lives caused by trauma and I respect and honor that they are not ready to go public with their pain. I promise that this will be the last of my laundry list style posts, but I will visit my own struggle, past and present, in posts to come. I will shed light on the “lost years” via stories about the people who helped and those who capitalized on my weakness. Thank you for writing. And please continue to write to me. Please comment. It is part and parcel of my recovery.

Anais Nin said, “People living deeply have no fear of death.” It’s true that most of us who backpack one or two standard deviations farther out toward the horizon have little time to ruminate about death. We were too busy living it…

Wounded writers, artists, athletes, explorers, abuse victims and warriors have one thing in common: We don’t fear tumbling into the abyss again as much as we are terrified of returning to routine and normalcy after trauma has dilated our senses. As the old joke goes: It is not the fall that will kill you, it’s the sudden stop. The body, no longer protected by endorphins, neurosteroids and adrenaline screaming into every cell, is suddenly left without properly functioning emotional or physical battlement to help protect against the worst memories of our descent and of the collision: these are sights, smells and sounds that throw the body into full defensive mode and at the most inappropriate of times.

Part of the issue can be explained by classical conditioning. Pavlov’s Dogs salivated every time a tone, that had been paired with food many times, sounded. The same can happen with trauma. Everything nearby can trigger a chemical memonic. And you cannot simply will, meditate or exercise away this kind of anxiety.

One unethical experiment from years past demonstrates the negative biological power of adversity. Humans are hardwired to be afraid of two things: heights and loud noises. Knowing this, experimenters presented an infant with a very huggable looking rabbit. But, each time the child reached for the animal the behavioral scientists would crash a large cymbal behind him.He would fall forward in sobs and tears and in no time at all the child panicked at the sight of anything resembling a rabbit. His system had been trained to react. No talk therapy was going to convince a traumatized baby that rabbits were anything but terrifying. It is no different in sexual abuse, domestic violence, accidents or combat. Those things in and around the stress become associated with it. The generalizations can be specific and narrow or disturbingly broad and can emotionally charge other things seemingly unrelated to the original event: sights, sounds, colors, time of day….. And these episodes can become so debilitating, they will destroy your trust that anything or a anywhere can be safe and you are left believing that it might be better to take your own life than to be visited by more anxiety or depression. Our willingness to face adversity in the first place is not always equal to our ability to handle its consequences. And because it is biological in nature it should not reflect poorly on the victim’s character or strength. Take for example the admission by Medal of Honor recipient Dakota Myer this week. He was so debilitated by his experiences that he attempted suicide. He is a hero again for talking about the price he paid for his bravery.

A couple of weeks ago I was the first car behind a particularly grisly accident. An open top jeep had flipped, rolled and then ploughed its way from the interstate into a forest preserve boundary fence. The driver, a young man in his twenties, was in shock and thankfully couldn’t feel the multiple compound fractures, bones protruding through his skin. I called 911, rendered simple aid and kept him warm and reassured. It wasn’t until after the ambulance left that I noticed how fast my heart beat of how shallow my own breathing had become. And I wept as much to release the scene, mourn my own past traumas and because I was incredibly sad for a man whose life was altered much too soon. It is my nature to run toward adversity and danger, but only if there is little tome between the event and my intervention. Any delay, and stress will debilitate me.

My anxiety has spread to things I once loved and to tasks that I once performed with ease. On my trip to Detroit I made a trip to Canada to test my passport. I had laundered it in a commercial washer and since it looked a bit worse for the wear, I did not know if it would pass border inspections. It did, but caused me irrational tension during the discovery. I told a friend when I returned how nervous the experience had made me and she replied that she understood because most of us are a little jolted by immigration inspections. Yes, but it is a matter of degrees. My resting heart rate is now 95-110. A few short years ago it was 46-48. To hit the gas and spur a corporeal engine already running all-out is nothing short of terrifying.

Since the 90s I have daily experienced most of these symptoms:

–Insomnia. It is hard to get to sleep and hard to stay asleep.

–Night Terrors. At least 2-3 times a week I wake almost numb with fear though cannot remember what I was dreaming about. I sit up in bed in the midst of dreams and for minutes at a time before I wake do not know where I am. This can be pretty upsetting for anyone spending the night.

–Reactivity to loud noises. I go to the theater often, but at hours when few people are there so they won’t be bothered when I leave to recover from the THX or Dolby blarings of a Hollywood movie. When my chest hurts so badly I think I might be having a heart attack, I head for the lobby. Theater staff know me by name now and are kind beyond measure. Car horns, intense arguments, and alarms can bring me to the brink of panic.

–Crowds. I will avoid large gatherings. I have turned down over 100 speaking opportunities in recent years. Where I was a keynote presenter in years past it is rare for me to even be a panelist. And if I do participate I have to work so hard to stay calm that I am exhausted by the end of a presentation. The response cost is terribly high. I become disoriented and confused in traffic and busy malls. It is best for me to avoid them. China is a bit problematic as it is always crowded, everywhere.

–Sudden contact from someone I do not know. I am not proud of the fact that I have wrist locked, hip tossed or otherwise subdued several people over the last few years after being surprised or assaulted. I am not proud of the fact that I have put people on the ground from Tiananmen Square to Stockholm, Sweden. Well, except for that thief at the Summer Palace …But, I digress. Even were I not a Hapkido Master, my extreme fight or flight reactions would make me a dangerous adversary.

–Heights. I used to love rappelling backwards off a helicopter skid. Now, I cannot cross a pedestrian bridge without a crippling rush of adrenaline. I visited the Dunhuang Buddhist Grottoes on the Silk Road this year and had incredible trouble navigating simple scaffolding only 1-2 floors above the ground. I am humiliated when I have to chart a course down the center of an overpass and run across to keep from being stranded in the middle by fear.

–Creativity. I stopped writing poetry the same year I won a National Endowment for the Arts Fellowship in Literature. The medication I had to take robbed me of ambition and original thought. The struggle is whether to be stress free, but with a chemical lobotomy and the artificial anger that it creates, or to fight anxiety ocean with a sword. The latter seems a bit more heroic.

–Coffee, Epinephrine… More than a single cup of coffee may well render me too stressed to drive and conversation comes to a halt because I am trying to keep my body from accelerating into a panic attack. I don’t like shots and won’t ingest anything that might hype me up.

–Memory. I once had a nearly eidetic memory for certain things. Years after they graduated I could tell students where they sat in my class and could remember names and details about their lives even if we were not close. These days I have trouble with recall and it is not unusual for me to forget the simplest things, much less long term data (CRS)…This is likely due to the side effects of the Klonopin doctors put me on years ago and because parts of the brain are actually destroyed when under constant pressure. The desk clerks where I live have spare keys at the ready and have retrieved dozens of things I have left behind. They now assume that any lights left on in the parking lot are mine. They kindly say that all is not right in the universe if I have remembered everything. I have a number of task lists, but they do little good when you can’t locate the list 😉

–Egress. I study a room to make sure I can exit and can defend myself if a problem occurs. I do not need my back against the wall, but I need a clear field of vision. I have noticed at the VA that new hospital staff will often walk directly behind some of the vets. The docs will look puzzled when the patient stops and glares as he lets them pass. Nobody likes to be “snuck up on” but PTSD sufferers like me are especially hypervigilant and much easier to threaten.

–Hypervigilant. I love the Psychic Detective show on TV as I am pretty similar to the protagonist. People watching has always been my hobby, and clinically I am a great diagnostician. These days, it is a survival response. I scan everyone in unfamiliar places. It is a threat assessment. That is why I frequent the same restaurants, gas stations and coffee shops day in and day out and get to know the people there. It is less tiring than being overly alert.

–Social Interaction. I am either too talkative or not talkative enough until I get to know you. I was a champion speaker and professional communicator. These days I’m just happy to survive a conversation. It is why I am anxious to get a service dog: A buffer and grounding tool when things are too much to handle. Too, I avoid conflict now. It has led to disastrous ends in some situations. In China unethical folks took great advantage of my detours around confrontation and I was cheated by a number of folks and always took the financial and reputational hits for the consequences of my avoidance. For the record: I own the failures and am still working to make amends where they are due. There are a handful of folks that should be aware that they are not yet off the hook for their transgressions.

–Confidence. Nothing will erode your confidence like this. To go from successfully competitive to incapacitated is a journey I pray you never take. And people will be sympathetic to those with physical difficulties, but suspicious and unforgiving with those struggling with mental health struggles.

My world view has changed because of this. I think the public and business worlds are basically bad, with a few good people in them. I am thankful to many of those few good and trustworthy people in my camp. It may sound devastating. And there are days that it is unbearable. The good news: I continue to learn how to accommodate for my issues while not expecting it from others. I will survive this as best I can. I am still competitive and determined, most days, that PTSD won’t deter me from finding a way through this while helping others in the process. It truly is about the journey and I intend to enjoy every bit of it I can.

Where self will comes in is this: It would be easy to give up and spend my days holed up like I was years ago afraid to go outside. But, to desensitize you must have experiences that train your body to let go of fear and let stimuli that once were your enemies assume neutral or helpful roles. Eleanor Roosevelt said that you gain strength, courage, and confidence by every experience in which you really stop to look fear in the face. You must do the thing which you think you cannot do. I gave up Tae Kwon Do, Writing, Speaking, Teaching. Everything I have accomplished these years has been in spite of this goddamn disease.  More to come…

 

 

 

Today’s call to action:

Follow Patriot Paws, a service dog training organization that provides help to people with emotional and physical disability. They do charitable double duty by training prisoners how to train dogs. Their students have a 0% recidivism rate.

On Twitter: @patriotpaws

On Facebook: Patriot Paws

VA Math

I have a friend who was rated by the VA recently for a several serious medical conditions brought on by military service. His ratings were:

Diabetes brought on by Agent Orange exposure:     80%

 

PTSD from numerous firefights:                                 50%

Lost of vision in one eye:                                                30%

Degenerative disc disease caused by multiple injuries while serving as a paratrooper over 8 years:                                                                                  20%

Hearing Loss in both ears:                                             10%

Final Disability rating by the VA :                                 90%

Total Award:                                                                      $1,661 a month

Surprised? I will tell you below, after a short digression, how that is possible. Chinese math has nothing on the VA version….

When I was stationed at Ft. Sam Houston I roomed with a college educated draftee who was also teaching at the Academy of Health Sciences. He was less than enthused about having to wear an enlisted man’s uniform and was generally part of G2 (Intelligence) for any anti-authority prank that was pulled in our department. I came home one day to find him reading  The Officer’s Handbook. When I asked him why he had bought it he replied, “Sound philosophy, Lon: Know your enemy.”

While I don’t consider the VA an enemy, for there are a host of caring and dedicated individuals employed there, the system is clearly broken and in dire need of repair. To reform a system you must understand it. From time to time I will post articles to help you understand VA benefits and some of the barriers vets encounter as they try their hand at the toughest confidence course of their careers. I have found that few vets really know how it works so, I will try to explain in plain language.

The VA awards benefits based on a rating decision made by a specialist in one of 16 regional offices. The specialist begins with the most severe condition first. In this case the diabetes. He rated the vet at 80% disabled. Note: He had to be pretty sick to receive a rating that high. Next, he is rated for PTSD. 50% indicates he is functional, but debilitated. So, the rater now applies VA math: At 80% disabled he is thought to have 20% usable resources remaining. So, he is thought to be only 50% of the good 20% disabled. That ups his disability rating by 10%. Then the rater applies the formula to his disc disease: He has 10% usability left and 30% of the remaining 10 points of usability allows him to add 3% more to his total rating. His hearing is rated at 10% (the maximum they allow for claims) and that brings him to a grand total of 94.96% disabled according to VA math. And the VA rounds up at 95% and rounds down at 94.9% so, he is 90% disabled. and paid at that rate.

He/she can, if completely unemployable, receive compensation at the 100% rate ($2700), but must apply and be evaluated again. That takes another 6-16 months. It can be sped up if the veteran is certified as homeless by the VA, but the documents proving that could take 3-6 months to be entered into the file. The VA can give 100% unemployability, but does not seem to very often. One vet who had fought for his 80% rating for over a decade had not worked in ten years. He is still waiting for an unemployability decision.

So, for those of you who thought our wounded warriors were headed off to Aruba with their largesse, just do the math… It is difficult to get benefits and the ratings often vary wildly and do not always reflect the severity of the problem. A lot of money and personnel are being thrown at the problem. Here is hoping it works sometime before vets waiting for answers and benefits pass away.

I will post soon about how the VA arrives at a rating for each disability. That too should be an eye opener.

 

 

My PTSD (Part I)

“What the mind doesn’t understand, it worships or fears.”
― Alice Walker

PTSD  has now become a part of our lexicon. PTSD hashtags appear on Twitter feeds in reference to everything from a chance encounter with a spider in a trash bin to more serious revelations by survivors of sexual abuse, combat, accidents or tragedies like the one today in Aurora, Colorado.

I began working with PTSD in the 70’s when I was a behavioral science instructor and field placement supervisor at the Army’s Academy of Health Sciences and later while assigned as a therapist in the outpatient psychiatry clinic for the Army’s 97th General Hospital in Frankfurt, Germany. The Vietnam war had officially ended in 1975, but soldiers of my generation, entrenched within themselves, rarely spoke of their time “in country” and still could not connect many confusing thoughts and actions to their battlefield experiences until their symptomatic storms raged so severe that they were ordered to see me. For them, the war was hardly over.

And after my discharge, in later years, I was a Certified Employee Assistance in charge of front line counseling for senior employees of the city of Raleigh and Wake County in North Carolina. It was there that I guided police officers, fire chiefs and health care workers through the guilt, shame and torment they experienced because anxiety debilitated them. Shootings, being surrounded or assaulted by a mob in a riot situation, having to performing triage (deciding who would be best left to die at an accident scene and who would be a survivor if transported first to the hospital), carrying screaming burn victims from burning homes, and former soldiers who just could not make nightmares stop were part and parcel of my day. And too, there were rape and molestation victims, intensive care nurses who simply couldn’t bear to see another patient die and their families who had become no less distressed. They stayed in difficult relationships hoping the person they once loved would reappear from the ashes of anguish and self-destruction.

Fiction writer Dean Koontz once wrote that, “Because God is never cruel, there is a reason for all things. We must know the pain of loss; because if we never knew it, we would have no compassion for others, and we would become monsters of self-regard, creatures of unalloyed self-interest. The terrible pain of loss teaches humility to our prideful kind, has the power to soften uncaring hearts, to make a better person of a good one.”  I am still learning those lessons. And in some ways I am a better person for enduring PTSD for decades. I will share the stressors with you in future posts, but suffice it to say, I have been abused, psychologically,medically and physically, and endured torture in ways only concentration camp survivor or POW might understand. I will share some of what I experience here in hopes you better understand issues surrounding PTSD:

Post-traumatic stress disorder symptoms typically start within three months of a traumatic event. In a small number of cases, though, PTSD symptoms may not appear until years after the event and they may be triggered during other stressful periods in a person’s life.

Post-traumatic stress disorder symptoms are generally grouped into three types: intrusive memories, avoidance and numbing, and increased anxiety or emotional hyper-arousal. I had many symptoms for years, but became totally overwhelmed in the middle of a meeting. My heart rate jumped to 140 and I couldn’t breathe. I thought I was going to die.

The hospital where I worked tested me for cardiac issues. I had none. I was having panic attacks. The doctors prescribed mild anti-anxiety medicine that had little or no effect. The panic attacks increased and soon I was having up to five a day and they would last between 5 and 40 minutes each. Imagine being on a balcony one day when when you experienced a sudden feeling like you might fall or even jump.Most of us have felt that at least once. Now, multiply the confusion and fear you had by a factor of two or three and you are close to feeling like I often did without warning or provocation.

At the time I was teaching college courses in Psychology, lecturing at national conferences across the country on wellness topics, I had just won a National Endowment for the Arts Fellowship for my poetry, I was an international Tae Kwon Do Master Instructor and had begun feeling reasonably successful professionally in most areas of my life. I had managed my symptoms up to this point (hid them well) but, those days were clearly at an end.   All I wanted  to do was hide from any responsibility, anything that might cause stress. I prayed nightly that I would die in my sleep before having to endure, or putting friends and family, through another day of terror. I thought I would gladly give up an arm or leg if the anxiety would just stop. Suicide was never a distant option.

Then came the constant reliving of traumatic event for minutes or even days at a time. My sleeping habits were bad before, but horrifying dreams, and night terrors now dominated.  I became housebound. I tried to avoid thinking, talking or engaging in any activity that might trigger an attack or increase my anxiety. I was hopeless about the future. I couldn’t concentrate and I had trouble remembering events both near and far. All my relationships suffered as I worked diligently to hide how far I had fallen.

I was easily angered, though too weak and afraid to be much of threat to anyone unless cornered or assaulted. I was easily startled and often heard or saw things that simply were not there. I over indulged in anything that would distract me from my anxiety: Drinking, television, gambling….

I tried to return to work. I tried teaching, but was carried out of my classroom once by paramedics. I was lost for an answer. Finally a military psychiatrist proposed a long-lasting benzodiazepine. The panic attacks stopped, but my personality changed. I was depressed, irritable and devoid of creative thought. And worse, I was seriously addicted.

A recent pop psychology article was titled “What doesn’t kill you, makes you weaker. There is more than a little truth to that if you understand the classical conditioning paradigms and the heavy toll negative events can exact from mind, spirit and body. When anxiety generalizes it is hard to get a handle on how to stop it from flooding every corner of your consciousness. You cannot just will it away. Drugs are one way out of the trouble and the Army and the VA have used them in excess. The effect of benozos is to behave and think like someone who has just downed three or four glasses of wine, but the effect lasts twelve hours. I often wish I had dived headlong into alcoholism. It would have been easier to kick. I stayed lost in a drug haze for over a decade….

 

 

Postscript: My heart goes out to the victims and families of the Aurora Shooting today. I know the area well: My father was evacuated there after being critically wounded during a mortar attack in Vietnam. My sorrow is miniscule in comparison to the pain that must be felt today. I pray for the survivors and a speedy recovery from senseless physical and emotional wounds.