"That Prescription Is Refillable, It Will Be Mailed Within Five To Seven Days"

 

Bill in Germany U. S. Occupation Forces 1947

For about twenty-five years now I hear that recording after I phone in a prescription refill to the Veterans Administration. 

I have full Medicare coverage. I also have supplemental coverage with AARP (United Healthcare). My so called "free Medicare" (with supplemental) costs me $462.00 a month ($189 deducted monthly from my modest Social Security account - I had to start collecting early since I had no job at 62 - and $275 a month for my supplemental insurance. Thus I now pay $5,544 a year a year for medical coverage which doesn't include eye care, dental or hearing. The eye care is only covered by one eye examination a year, I pay for eye glasses which I just got at the discount B.J.'s for $417 (two pairs of eyeglasses - sunglasses one). My dental, which I need, I've paid thousands of dollars over the years out of pocket. For a short period of time when I had a full-time job in Philadelphia, I did have dental insurance which paid for part of my dental expenses, usually just the cleaning. Now days I pay everything out of pocket and as you know, if you go to the dentist it is VERY EXPENSIVE. I used to go to a gay dentist, not because he was gay (a coincidence) but because he was good and he was. But I stopped going to him because he took every Friday off to fly down to Miami Beach Florida to cavort with his gay friends at the former Versace home which is now a fou for restaurant ("fine dining"). It bugged me that I was contributing to that lavish and decadent lifestyle. Main reason I changed was because when I needed him for an emergency he wasn't available. I changed dentists and now I used another dentistry, which is also very good and expensive but at least I don't know where the money is going. But I digress. As usual, I start of a blog post with one thing in mind and my stream of consciousness takes me down a completely different path. Back to the subject at hand, my prescriptions.

Back when I was working at the bank for my main career (before hotel work at the end of my career), I had full medical coverage. Never used it once. Never. After I lost my job I figured I had better have some kind of coverage. I remembered the VA. When I joined the Army back in 1960 I was told I had "Free lifetime medial coverage.....if I needed it."  Well, I needed it then in 1994 when I was sans medical coverage. I didn't want to take a chance without medical coverage so I decided to swallow my pride and I made a visit to the VA to sign up. "Swallow my pride?", remember back then only poor, loser vets signed up for the VA. When I asked a good friend of mine if he was signing up, he said "Why should I? I HAVE a doctor and I have a job."  He was also of the entitled class who had everything handed to him basically his whole life. College education paid for by his family. Wife to take care of running his household which included everything from cooking his meals to running errands and paying the bills. One time we went out to dinner together and I casually asked him how much he was earning from his job and he said "I don't know." He said his wife "takes care of that." I was astounded. Didn't even know how much he made? Well, of course there came a time when he too lost his job, because he was of that age when corporation discard older workers even if they did work in Human Resources, which he did. He was in shock when he lost his job. Bereft of a plan, he broke down. Of course his wife took the reins again and studied their options and made a plan. Since he was eligible for VA benefits (he was drafted, God forbid he would ever join the Army voluntarily). So he swallowed his pride and applied at the local VA, the same VA when I had applied when I lost my job. He now receives his prescriptions through the VA and has no loss in status in his neighborhood. I was talking to him recently at the high cost of heart medication that both he and Bill take and he said "I get mine through the VA too."  My friend has come a long way, not ashamed to admit he gets his medications through the VA.I have to admit I was surprised hearing him say this but even he realizes the value of saving money because prescriptions can be and are expensive in this country.

There came a time during the Bush administration that the Republicans decided that they should save some more money but cutting the benefits to veterans like me, who weren't disabled and discontinue our VA benefits. You know, the Republicans of "we can never had too many tax cuts for our rich, corporate paymasters?" There was a predicable outcry from veterans organizations so the Republican controlled Congress decided to grandfather the benefits. Those veterans, like me, who were already receiving prescription drug benefits but new veterans would not. The Republicans instituted eight classes of veterans. Those who has no disabilities were classified at the lowest level, Class 8. Those veterans with disabilities received lower classifications. So if you were a blind, paralyzed, veterans missing limbs you would be classified as one, two or three. Bill is now classified as four, because of his blindness. He pays nothing for his medications. I am still classified as eight, and I pay $8 for a 30 day supply or $24 for a ninety day supply of medication, no matter what the medication. By the way, I changed my registration from a lifetime Republican to Democrat when the Bush administration and the Republicans in Congress tried to take away my promised Veterans benefits. That's when I realized the Republicans care nothing for the average man or woman nor do they honor promises. Remember when I joined one of the promises made was "Lifetime medical care.....if needed." Ironically after I lost my job at the bank and didn't have medical coverage, it was a good thing I signed up at the VA because shortly there after I needed two major surgeries. I also had two medical emergencies and needed medications. Thank God I had signed up at the VA. I wasn't too proud to sign up either, I earned those benefits. I put my life on the line for three years for that promise. The same as bill did for nine years of total service with both the Army and the Air Force when he was stationed with the occupation forces after World War II in Germany (Army)  and then Japan (Air Force). 

Bill had joined the Army when he left his home in Georgia. There was no promise of a paid college education for him either, his only choice to support himself when he left school was to join the service. That was also my choice. My Mother told me back in Nine Grade when it was time for me to choose a pre college course or other high school course upon entering high school. No comfortable golden path for us to enter adult hood. No fraternity, college campuses, beer parties, fun a frolic. Oh wait, there were beer parties and "fun and frolic", just with a bunch of other guys like us who came from more modest family circumstances (read "poor as shit.")

For many years I was resentful of my college bound friends whose families had the means to prepare them for a successful career in adulthood by paving the way for them by paying their college expenses. I guess I still have some of that resentment, especially when many of them took useless courses like "political science" (what the fuck is that?) or failed in college like my friend I spoke of earlier. He wasn't dumb, in fact he was and is very intelligent, more so than me. When we were in school together he rarely studied for tests but always got good grades, mostly A's and a few B's and never anything lower. And he did it with such easy. Maybe because his last name started with a "B" and he always sat in front of the class whereas I always sat in the back because my last name starts with a "T." I understand schools don't do that now, seat pupils alphabetically, because it causes psychological harm and it does. I can attest to that. And the fact that I was tall for my age I was always told to "stand in the back" whenever for group settings. Another blow to my fragile sense of self confidence especially me with a father he constantly mocked me and never gave me any reason for self pride. For my grades, mostly B's and some C's  and an occasional D, I worked for those grades. I'm still not the sharpest knife in the drawer but I work folks. And I work hard to make up for my lack of natural intelligence or brain matter. 

Some of us are just born smarter, what we do with our lives is our own choice. Others have to work at making our place in the world because little is handed to us. I think this is one reason why so many poor white men are resentful of minorities these days getting all the attention. They feel those minorities are getting free ride, which isn't true of course, why they have to work hard for anything they get. But again I digress into a political discourse. Been there, done that but it's not productive to rehash those old arguments again or as others say "beat that dead horse."

So I placed my order for a refill of my anti cholesterol medication last night and I am again reminded that at one time of my life I had the right decision. 

Note: there are more than a few times when I have made the wrong decision in my life but joining the Army wasn't one of them. One of the best decisions I ever made in my life. I learned more from my three years in the Army that I would ever have learned in eight years of college. 

The VA - Now Here's a Real Scandal

The Wilmington VAMC - the one that I use
(photo that I took 2012)

The Republicans have been floundering around trying to push faux scandals like the Benghazi, the so called IRS scandal, Fast and Furious, and even the kidnapping of those 300 Nigerian school girls that the Republicans are trying to blame on Hillary.  But now here comes a real scandal, the shameful VA (Veterans Administration) cheating scandal where some VA centers were caught falsifying records on how long it took for veterans to see their doctors. This folks is a real scandal.  See here.  But the Republicans better be careful before they jump on Obama for his failure (and it IS Obama's failure given his past speeches about fixing the VA) because they would not have done any better.  In fact, if the Republicans were in charge we probably wouldn't have a VA.  

One of my many visits to the Wilmington VAMC

This is one reason I am now a registered Democrat.  Prior to  2000 I was a lifelong registered Republican.  However, when George Bush and his Republican chicken hawk cronies  got into power in 2001, one of the first things they did was issue an order that the VA should stop marketing the availability of the VA to veterans like me.  Then they attempted to eliminate veterans like me from even accessing the VA and only making the VA available to veterans with service connected disabilities. This repugnant action against me, as a veteran who put my life on the line for three years with the promise that I would have lifetime medical care if I needed it, completed my transmigration from lifelong conservative Republican to a flaming liberal Democrat.  I was already traumatized by the 1992 Republican convention where Pat Buchanan gave his famous "culture war" speech which disowned and criminalized gays like me as not part of this country.  What really radicalized by was all the good Germans white folks in the audience enthusiastically cheering on his hate filled speech.

Hitler Pat Buchanan rallying The Cause to the Good Germans Republicans at the 1992 Republican Convention

The Bush Administration weren't able to drop me from the VA because there was such an outcry from veterans' groups.  Veterans like me, who had already signed up in the VA, were grandfathered into the system.  However, the Republicans and the Bush administration were successful in creating eight classifications of veterans eligible for VA care.  The classifications ranged from total disability (classification 1) to veterans like me (classification 8).  The Bush administration even tried to charge ($2,250 a year) for veterans like me to remain in the system.  Thankfully they were not allowed to get away with this outrage.  So Republicans, don't give me your false outrage now that President Obama has failed to keep his campaign promise to "fix" the VA.  I almost threw up yesterday when I saw Republican Sen. John Thune and his fellow vulture Republican senators make a statement about how "outraged" they were at President Obama.  

GIVE.ME.A.BREAK.  

Hey Thune, I'm outraged too but here's a clue Republicans……you don't have to do anything.  You're going to look like the vultures that you and reinforce your reputation for unbridled hypocrisy.  

So here's the deal folks.  There is a BIG.PROBLEM.AT.THE.VA. And yes, President Obama has fallen down on the job.  And Eric Shinseki should be removed from the VA.  He's hapless.  Did you see his "I'm mad as hell" moment the other day before the Congressional sub-committee?  I almost fell asleep while he was expressing his "outrage."  Wake up Shinseki!  No wonder not much is getting done at the VA.  Shinseki gives somnolent a whole new meaning. 

Mr. Excitement

You want "mad as hell"?  Here's MAD AS HELL (Howard Beale from the movie "Network")

As I mentioned before, I am a veteran and I use the VA.  There is a problem with getting timely appointments.  A BIG PROBLEM.  But I have to say this, I have always received excellent care from the VA…..once you get to see a doctor.  

I've had two major operations at the VA, both successful.  The VA monitors my health care every six months but taking lab tests.  The VA discovered I had prostate cancer.  The VA discovered that I had Gilbert's Syndrome (a non-life threatening liver ailment).  My VA doctor ALWAYS has time to talk to me.  The VA provides all my prescriptions at a reasonable cost.  Without the VA I probably wouldn't be here today typing this blog post. But folks, I'm one of the lucky ones because I'm already in the VA system and have survived despite the Republican efforts to kick me out of the system.

Having said this, now is the time to get the VA straightened out for this thousands of veterans who have put their lives on the line in defense of this country.  Now is the time for president Obama to wake up and take charge.  Maybe he will have to cut back on his time for greeting sports teams at the White House and maybe even fire Shinseki (who I'm sure he put in the VA to make up for Shinseki being sacrificed by the Bush administration by daring to state that the United State would need a lot more troops in Iraq if we invaded them).  Talk is cheap president Obama.  DO SOMETHING!   And you Republicans who are all so eager to jump on the Vulture Bandwagon and use the veterans who are suffering and dying from the way the VA is run now, have some human morality and join in helping to fix the VA so our veterans can have the proper care that they deserve.  

VA Outpatient Clinic - Georgetown, Delaware (the one where I see my doctor is is EXCELLENT!)

New Doctor

Tomorrow I have an appointment with a new doctor.  This is a general practitioner doctor.

Except for my near death experience when I was 17 years old (I got a staph infection from an unnecessary hernia operation), I've never had my own designated doctor.  That was good news because my health has been good all those years from 1959 until 2000.

In the year 2000, when I was without a job and didn't have medical insurance I did have a couple of health issues which required two surgeries.  Fortunately for me I had access to the VA (Veterans Administration Health) facilities.  I received excellent care from the VA.

However, recently I've been running into more medical issues and using the VA for every issue isn't convenient.  In order to use the VA I have to arrange a ride through the American Legion Post 28 to the closest VA facility to me which is in Wilmington, 90 miles away.  I can only have appointments in the morning and only Monday through Thursday in order to take advantage of the transportation to and from the Wilmington VA provided by the American Legion.

In the past few months I have had several skin cancer (pre-cancer thank God) on my face.  I just couldn't wait the two or three months I had to wait to make an appointment at the VA so I made an appointment with a local dermatologist.  I have Medicare and supplemental insurance which I pay a heft amount for every month, so I decided to use it.

I am receiving excellent care from the local dermatologist that I am using and it is much more convenient for me.  I'll think I'll forgo using the VA for my dermatology needs.

Now I am having some other problems like the one a few weeks ago in which my right leg was very sore.  I have no idea what happened to it but I couldn't bend my leg and standing up or getting out of a car I experienced excruciating pain.  I looked for a general practitioner doctor and was about to find one (purely by coincidence) right next to my dermatologist's office in Rehoboth Beach!  Another coincidence is his last name Kelly.  The same name as my Bill.

I have an appointment with him tomorrow.  The pain in my right leg is gone (I have no idea what happened) but now I have a soreness in my jaw.  It seems as if it is always something.  It is time for me to have a regular doctor.  My own personal "regular" doctor.  This is the doctor who is going to take me out.

As I've told my friends and co-workers so often, I am way past my expiration date.  I never expected to live past sixty years old.  Anything over sixty is gravy.  I'm working on bonus time now.

I'm still in very good health but little things are starting to go.  My eye doctor (who I see every year) says I have cataracts developing but probably won't need surgery for several years.  I do have a lot more aches and pains but with the exception of that very sore leg a couple weeks ago, I can live with the creakiness that is normal everyday for me now.

However, it does give me a feeling of comfort to know that I can call and make an appointment fairly quickly in case something develops in the future.

I now have an excellent dentist, eye doctor and dermatologist.  With this new general practitioner doctor that I will see tomorrow I will have all my bases covered except maybe for a shrink.

A Day at the VA

The Wilmington Veterans Administration Center

Yesterday morning my alarm went off at 4:30 am.  I had an 8:30 dermatology appointment at the Wilmington VAMC (Veterans' Administration Medical Center.)

I have to get up so early in order to get ready to catch the American Legion Post 28 van at 6 am that hauls us old vets all the way to Wilmington so we don't have to fight the early morning traffic ourselves.

The way I look early yesterday morning - not my usual perky self

The van picked me up at Rts. 1 and 5 by the liquor store.  In addition to Tim driver, there were four of us old grizzled vets that would be transported to the gleaming VA in Wilmington this morning.

Traffic was heavy as we rolled onto I-95 then Rt. 141 before we made the final turn on Kirkwood Highway and entered the VA at about 7:15 am.  Construction work was going on outside the entrance to the VA (the VA is building an extension to their emergency room facilities) so Tim took the van around the back of the VA and we entered through the basement past the coffee shop.

Since my appointment wasn't until 8:30, I thought it was a good time to take some random pictures of this medical facility which has taken such good care of me since 2001.

The main elevators at the Wilmington VAMC

All years I had this wonderful insurance at the banks were I've worked I never used their insurance once.  However, wouldn't you know it that once I lost my job at the bank I had some medical problems.  That's when I had no other choice than to take advantage of the promise made to me when I joined the Army way back in January of 1960.  The promise made to me if I joined active duty for three years was that I the Army would pay for my college education (which they did after I got out) and lifetime medical care "if I needed it."  Well, I needed it back in 2001.  Of course I was reluctant to use the VA because I heard all those horror stories about how badly they cared for the veterans who used their facilities.  Well, that may have been in the past but it has not been my experience.  Since I started using the VA, I have received the best medical care in my life.

After taking a few pictures around the VA premises, including on of the pictures of President Barack Obama and General Eric Shineski (the administrator of the VA), that were prominently hanging on the wall in the lobby (what a pleasure not to see the smirking face of our former president George W. Bush whose administration tried every trick in the book to minimize and eventually take away veterans benefits), I took the elevator to the sixth floor and awaited the team of dermatologists to arrive from Thomas Jefferson University of Philadelphia.  As I said, we receive the BEST medical care.

A welcome sight after having to look at George W. Bush's picture for the past eight years

Back in 1992 when I first discovered I had the precancerous condition known as keratosis, I was working at Fidelity Bank at Broad and Sansom Streets in Philadelphia.   The place where I went for my treatment was just a few blocks away from the bank......Thomas Jefferson University Hospital!  A Dr. Uy an his team of interns (he asked my permission if they could look on while he treated me) looked on, he determined that I had a bad case of keratosis which needed topical chemo therapy treatment.  He also told me that for the rest of my life I would have my skin checked by a dermatologist to prevent skin cancer.  This was my reward for all those years of baking on the beach.  The warnings are true!  Early exposure to the sun WILL result in skin problems later in life.  How ironic that I now live in a beach resort area but I never go to the beach because of my skin condition.

The dermatologist who saw me yesterday was Courtney.  She is the same dermatologist who saw me six months ago.  We're becoming friends.  She checked me out and only found a few small spots of keratosis which she quickly burned off (didn't hurt at all.)  She told me I looked good (something I already knew.)  She suggested that since I "looked so good", it probably wouldn't be necessary for me to make a return visit every six months, but instead return annually.  I agreed with her suggestion and made an appointment to return next year.

Courtney, my dermatologist at the VA

I left the dermatology department and returned to the first floor lobby area of the VA to meet up with our driver Tim and await the other veterans who came up in the van to return from their appointments.  We were lucky today because everyone was finished at 10:30 am and we were on our way back to LSD (Lower Slower Delaware.)

The waiting area in the lobby of the VAMC - this is what socialized medical care looks like

Ah yes, a good day.  But my day wasn't over.  Yesterday afternoon I had scheduled for my PC Guy to come over to the house and configure my three PC's.  More about that in a future blog posting.  This morning I have to get ready for my refinancing settlement scheduled for 2 this afternoon.

Tim, our van driver awaits me. This is what socialized medical care looks like. We vets care for one another.  

There always seems to be something going on around the Tipton/Kelly household.  As I postulated before in a previous blog posting.....what did I do before retirement?

Visit to the VA

I missed my ride to the VA yesterday.




As Bill and I sat waiting in the early morning murkiness that is the parking lot of the liqueur store located at Rt. 1 and Rt. 5, I had an ominous feeling that the American Legion van wasn't stopping by to pick me up. I was right.



Six o'clock rolled around. No van. It is now six fifteen am and still there is no van. Maybe they're late. "No", I tell Bill,”they're not coming." Six thirty and it is now daylight. We're still in the parking lot waiting in vain for a ride that will never arrive. I call the van coordinator, waking him. Still half asleep, he told me he put me on the calendar at the American Legion. Then I thought "I didn't tell him to pick me up at Rt. 1 and 5." Ah ha. My fault.



My appointment at the VAMC in Wilmington was for 9:00 am in the dermatology department. I told Bill he will have to take me to the VA. It's a 90 mile trip one way. One plus is now we could give his new GPS a real test. Off we went to Wilmington in the early morning traffic. This was not what Bill had planned for this day.



The traffic wasn't as bad as we had feared. We only made one wrong turn (taking Rt. 141 south instead of Rt. 141 north.) The woman's voice (She Who Must Be Obeyed) on the GPS quickly recalculated and we quickly corrected our course. We arrived at the VA at 8:20, plenty of time for me to check into the dermatology unit. They request that you be there at least 15 minutes before your scheduled appointment.



A young intern from Thomas Jefferson University examined me for any skin cancer problems. She found three areas of actinic keratosis on my face. One was right in the middle of my forehead and two on my left sideburn. She burned them off with a dry ice spray. It burned. Now I have a red dot in the middle of my forehead. With a turban I could pass for one of those Pakistani sects.



After my treatment I went looking for the van driver in the main waiting area of the VA. The American Legion Post 28 of Oak Orchard provides a van four days a week for any veteran from Slower Lower (Sussex County Delaware) who wishes to avoid driving to the Wilmington VA. It is very generous of them. We can contribute to the cost if we want to but it isn't necessary. Most of the vets contribute $10 or whatever they can afford. No one keeps records.



I locate the van driver and tell him who I am. He shows me his list and I see a note next to my name as a "No Show." That's what we have at the hotel where I work, "No Shows." That's people who make reservations who don't show up. I'm a "No Show." I was mortified. I apologized to him and told him that I neglected to tell Tim (who I made the reservation through earlier in the week) that I was to be picked up at Rts. 1 and 5. The driver grunted and then shifted a bit to continue waiting for the other five vets who did show up. He was finished with me. As I left I gave him a light pat on the shoulder and I saw a hint of a mile. Maybe I redeemed myself.



Bill and I headed back home, but not before we made a pit stop at Sam's Club in Dover. They have the best rotisserie chicken. The absolute best and it only costs $4.97. We also did some other shopping before heading home. We were home before noon.



I made myself some lunch then took a nap prior to going into work at the hotel. My co-worker on day shift had called me on my cell phone while I was in the waiting room at the dermatology clinic and asked me to come in early for her because she had to pick her daughter up at school. I could do that.



Last night at work was uneventful except for the fact that one of the guests complained on a comment card that she almost fell on the wet tile floor I was mopping Saturday night. The owner stopped in and wanted to know what happened. I explained to him what happened which was that I was mopping the tile floor at 10:30 at night and the guest returned to the hotel with her husband and on her way to the elevator she almost slipped on the wet tile floor (which I did not have a sign that said "Wet Floor".) I didn't know there was a sign. Now I do. I mopped the floor last night and put the sign down which I must say makes me feel more comfortable when I mop the floor. No guests came in this time though to walk across my wet floor.



I finished my shift with an aching back which I usually do because I spend the whole eight hours either standing for sitting on a stool. I have no back support. Try that for eight hours. No complaints from me though. I'm appreciative that I have a job.



Thus I just finished one of my "Daily Journal" blog entries. Look for changes to come to this blog in the near future. I have been inspired by another blog that I recently read called "Ramblings of the bearded one." His name is Kim Ayres (yes, like me he uses his real name) and he lives in Scotland. I find his blog very interesting and readable. Up until now the only blogs that I have found interesting are of two friends of mine. Their blogs are interesting because they are well written and because I know them I find their lives interesting. However, up until now I haven't found a blog of a stranger as interesting because the ones I have read are either too off the wall, badly written or on arcane subjects I have no interest. I thought I would be interested in gay blogs but they are among the worst I've ever read. Kim is straight but that is beside the point. He is an excellent writer and he writes blogs that are thought provoking, serious, and funny at all the same time. This man has a talent that is unfiltered and unfettered by some arbitrary editor or publishing company. His blog for me is a pure joy to read. I'm going to steal some of his ideas to make my blogs more interesting and readable.



The only constant is change. I will continue this conversation later.

Single Payer Health Care System

Up until a few days ago, I was a strong advocate of single payer U.S. health care. However, an experience with the Veterans Administration health care system last Tuesday caused me to lose some if not all of my confidence in a single payer system.

Since 2001 I’ve been using the VA health care system. I didn’t have a choice when I lost my job at the hotel where I worked in Lionville, PA. Luckily for me I had signed up for the VA health care system in 1998 just in case I would ever need it. Lucky because in 2001 the Bush administration discontinued the eligibility of non service connected (meaning we didn’t have a service connected disability) veterans like me from using the VA health care system which I was promised when I joined the Army in 1960. This act alone (making veterans like me ineligible to use the VA system) was the main factor in causing me to change my political registration from Republican Party did not care for me or my well being unless I was connected to the power structure. Since I neither was employed, rich or have political connections, I was on my own according to the Republican Party. My first doubts about the Republican Party began during the 1992 Republican Party convention in Houston Texas after the hateful homophobic speeches of Pat Buchanan and Pat Robertson. That was my first clue that I, as a gay man, was not welcomed in the Republican Party unless I turned straight. But that is another story for a future blog posting.

The VA health care system was a lifesaver for me. During the time I was unemployed I had one medical emergency and two operations. The VA took excellent care of me. In fact, they took better care of me than my private health care ever did. The one major operation I had with my private health care system almost killed me. I contracted a staph infection and it took me six months and three operations to finally get rid of it. I barely survived. The whole ordeal was a nightmare which I will never forget. I never received an apology from any of my private medical care providers for what happened to me, including the doctor I went to who insisted it was "all in my head" when I complained of horrendous headaches. It was only when my surgery scar burst from the build up of pus that I was delivered to the contagion ward of the hospital in an ambulance. Then the medical establishment realized that something was dreadfully wrong.

I liked the VA health care system because they seem to really care about me. I wasn’t just a number to increase the doctor’s volume of patients. The VA had a different attitude. Since they’re not operating for profit, they took more time with me. My doctor (or nurse practitioner) actually sat down with me and made eye contact with me and discussed my health. I had annual labs to monitor my health. Except for the fact that since I moved the main VA facility was now 90 miles away (as opposed to ten minutes away when I lived in Pennsylvania), I was very happy with the VA system. No, I couldn’t choose my doctor but I always had the best doctors available for me when I went to the VA for care.

Alas, it seems that has changed now. Last year the VA opened an outpatient facility in Georgetown. No longer would vets like me have to travel 90 miles one way to Wilmington, DE just to take labs or to visit our doctor. Now we could travel to the outpatient clinic in nearby Georgetown. It all looked good on paper. However, what looks good on paper and what is reality are two different things.

I have visited the VA Outpatient Clinic in Georgetown about a half a dozen times. Every time I have visited them I have a different doctor. This wasn’t good. There was no continuity. The last time I visited I had a doctor and I expressed my concern about the turnover. He assured me he would stay there because he said he liked treating “old vets” like me. I think that was a compliment. So imagine my disappointment this past Tuesday when I visited the VA Outpatient Clinic for my labs. A lot of red flags went up.

First, there was no sign in sheet. There were no instructions as to what to do. I see the obese woman behind the glass partition (what’s with the glass partition? Afraid someone is going to rob them?) I asked her “where is the sign-in sheet?” She looked up at me with a dull look and said “Hepa.” I said “Hepa?” She repeated “Hepa.” I said “Oh, it’s a privacy thing?” She said “Yeah.” Okay. Then I tell her I have an appointment for my labs. She now asks my name (why didn’t she do that sooner?)

I take my seat. A short time later a woman in a white medical jacket comes out and proceeds to rip a new one for one of the veterans. I don’t know what he did but she said to him “Sir! You will have to wait your turn! There are 30 other patients before you and you will have to wait your turn! Do you understand?” Oh that was nice. Not what you would call professional or respectful. Even if the vet was inquiring about when his turn was I don’t think that was an appropriate way to answer his question. The woman turns on her heel and stomps in the back to continue doing whatever it was she was doing before this hapless vet dared to ask his question. An uncomfortable tension settled over the rest of us vets in the waiting room. What next?

Then I was called into the back to get my blood drawn for my labs. It was all very organized, including the needle at the ready. My brother had told me a few weeks earlier that whenever a medical person inserts a needle into your arm you should see them break open a new needle and throw that needle away. I didn’t see that and I’m ashamed to admit that I didn’t question it either. I should have. I was intimidated by the white jacket woman who was administering a needle to the veteran sitting next to me. Yes, they were taking our blood simultaneously. Yes, we were on a production line.

After three vials of blood were taken from me I returned out front and inquired as to when my next appointment would be. The usual procedure was to schedule an appointment the next week to go over the results of the labs or blood test. I was told that they would contact me “if there was a problem.” Otherwise, if I wanted a copy of my labs I could call them next week. So there you go. No longer did I have a doctor, or even a nurse practitioner to discuss my medical condition with me. I wasn’t asked if this is what I wanted. The decision was made for me.

Another incident which also caused me great concern was that they had no record of my partner Bill. He had not heard from them in over a year about getting his labs. He went with me and inquired at the front desk. He was told “You’re not in the system.” Not in the system? He’s been in the system since the early 90’s. They made an appointment for him and also a follow up appointment to review his labs. Why didn’t they make a follow up appointment for me?

As I was leaving I overheard another vet questioning the person at the front desk as to why he had not received his heart medicine. The woman at the front desk didn’t seem to care. The old veteran was pleading with her that he needed his medicine. She finally advised him to see the woman around the other side of the front desk. Hopefully that woman took care of his problem.

All these events on this past Tuesday morning in the span of about a half an hour left my confidence in the VA health care system very shaken. It has even affected my sleep. That’s when I know something is serious because I rarely have problems sleeping. I can sit in front of a TV or read a page or two of a book and I’m off in Wonderland in only a few minutes. Not now, I’m waking up during the night worried about my health care.

This morning I decided to do something about it. I called the VA in Wilmington and explained my concern to the operator. She immediately connected me to a woman who is the patient’s advocate for veterans. She wasn’t in so I left a message. Much to my surprise, she called me back in about 20 minutes. I told her of my experience at the Georgetown outpatient clinic and explained my concerns. She told me that the Georgetown clinic was having a great deal of difficulty keeping a doctor. She said part of the problem was probably the computer system which was frustrating to use for the doctors and nurse practitioners. She seemed genuinely concerned about my loss of confidence. She offered to reconnect with a primary health care provider at the Wilmington location. She acknowledged that it would be a long trip for me but I told her that didn’t concern me as much as I needed a primary health care provider. The trip by the local American Legion Post 28 van takes up half of my day. That is a small price to pay for the peace of mind to have a permanent, consistent health care provider with whom I can discuss my medical condition.

The lesson I am taking from my experience this past week was even though I ran into difficulty with the single provider system that I’m using through the VA, I was able to resolve the problem immediately through the VA’s patient advocate and thus stay with the system that has provided me the best health care I have ever received in my life. I have regained my confidence and peace of mind and now I can sleep again at night.

My Trip to the VA

Four-thirty a.m. came around early this morning. I knew I had to get up early so, of course, I was awake at 3:10 a.m. I slept in fits and starts until my radio alarm clock sounded the alarm, “BEEP! BEEP! BEEP!” I rolled out of bed, wash, shaved, did my morning exercises (to get my blood flowing), and ate my breakfast. By this time 5:25 a.m. had arrived and Bill was ready to drive me to liquor store at Rts. 1 and 5, where the American Legion Post 28 van would pick me up. Out of the house into the dark cold air, I climbed into Bill’s ancient Jeep. Ten minutes later we were at the pick up point. Another veteran was waiting there in his car. About 20 minutes later the van arrives. Only the driver and a World War II submarine veteran who was riding shotgun were in the van. Usually the van is full. But, this morning three vets cancelled and one was a no show. The other vet and I climbed in behind the driver and the submarine vet. Right away I made a mistake. I was behind the driver and he had his seat all the way back. I have long legs. The ride to Wilmington is a good hour away. My long legs would be cramped. They were. Plus, I didn’t have an arm rest. My ride to the V A Medical Center in Wilmington was very uncomfortable. I tried to take nap on the way up, to make up for lost sleep time. All I accomplished was more fitful sleep. Arriving at the VA building in Wilmington, it was now daylight. The air was still cold. I made my way up to Room 2115 for my 9 a.m. appointment for my CAT-RAD scan. I checked in at the desk. The receptionist told me to take a seat. First I had to drink five full glasses of water. One hour prior to the CAT-RAD scan I was given instructions to drink all this water. I knew this would be a problem. I just don’t drink that much water. That is why I have kidney stones, which is why I was getting a CAT-RAD scan today. I brought my own plastic glass with me. I went out in the hallway and positioned my glass under the water fountain. One glass I gulped down. Already I had enough. I drank another glass of water. I’m bloated now. Three more glasses to go. I turned the fountain on again and filled my glass. Gulp! Now I’m getting nauseous. I walked up and down the hall, sloshing all the way. The time was only 7:45 a.m. so I had a while to go. I waited about 15 minutes then took another gulp of water. Oh my God. I’m about to float away. I only had one more to go. I steeled myself and filled my plastic glass up again and chug a lugged it down. Now I’m sick. I wobbled into the waiting room. As I passed the receptionist, she told me I had to go downstairs to get my “labs.” That’s VA talk for a blood test. Lightheaded, I headed for the elevator, got on, and got off the first floor. Checking in with that receptionist, I scanned my VA identification card. The VA is very organized. All a vet has to do is scan their card and their name comes up on the monitor and appointment information. So much better than private medical practice where it seems as if the front desk is run by bored clerical staff. My appointments at the VA are ALWAYS on time. There is none of the practice of making appointments for all patients at 10 a.m. in the morning or 2 p.m. in the afternoon. “Tipton?” My name was called. Rising, I follow the pleasant young lady around the corner and take a seat in a barber type chair and roll up my right sleeve. We exchanged pleasantries. She checks my arm for a vein. Pleased, she said “You have nice veins.” Thank you. She swabs my vein and takes the needle out, aiming for my vein. I look away. I can’t stand the sight of my own blood. If I see it, I’ll be on the floor. It’s happened before. I don’t want a repeat. “There! That’s done.” It was painless. I complimented her on her skill in not hurting me. Rolling down my sleeve, I left. Back to Room 2115 and the waiting room. Nine o’clock rolled around. The technician came out and called my name. I go into a room off to the side. He tells me to take off my shirt and lie down on a bed type contraption protruding out of the CAT Scan tube. I get on the bed (I’ll call it a “bed” for lack of a better word.) He puts a sheet over me and asks me to pull my pants down around my knees. He goes for my right arm again. I’m going to get an IV. Oh uh. He gets this BIG needle out and compliments me on my vein. “Nice veins” he says. Then he punctures it. OUCH! Damn. That hurt. He says “You have tough skin.” Funny, I thought I was thin skinned. Oh well. He tries again. WOW! THAT HURT! He says this time “Your vein rolled.” What’s that? My vein rolled? I've been rolled before but I don't recall ever having my vein rolled. Then he punctures me again. It is really hurting now. What is this guy, a sadist? I’m beginning to feel like a pin cushion. I noticed that he didn’t swab my skin with an anesthetic. What’s this? Was he bored? He didn’t seem too happy. Finally he got the IV in my vein. It was about time. And or course, it hurt the whole time it was in. Then we went through taking the CAT-RAD scan. In the tube, hold my breath, exit the tube, let my breath out. Three times I did this. Now it was time to take out the IV tube. Oh boy. More hurt. I probably sound like a baby don’t I? I think I have a pretty high pain threshold. But, I don’t know. I was punctured quite a few times this morning. I wouldn’t be good under torture. I would probably be the first to spill the beans then some. Finally, it was over. I pulled my pants up, took the sheet off, and left. I thanked the technician but on reflection, I wonder why. I’m not sure if he was all that good at administering needles. I expected my arm to be bruised. Looking at it now all I see is four puncture marks. It looks like I had a run in with Dracula and I put up my arm to ward him off and he missed and got my arm instead. Well, it’s all done now. The ride back was uneventful. About an hour after I returned home, I heard a knock at my door. It was the UPS man. He arrived with my new Dell computer. I’m working tomorrow at the Inn (still no guests) so I will have to wait until Friday to assemble all the parts. Damn, that needle hurt.

Veteran's Care

A short time ago, I returned from the Veterans Medical Center in Wilmington, Delaware. My appointment today was with the urologist. This was a followup to my kidney stone problem. Again, I was very impressed with the quality of care that I receive from the Veterans Administration. About ten years ago, I applied for my Veterans Administration card as insurance in case I was left without medical insurance. At that time I didn't that it was likely that I would ever find the need to use the Veterans Administration for my medical care. Little did I know. In 2001 I changed my job where I was covered with full medical care to a consultant job with no medical care insurance. Fortunately for me I had medical care with the VA which enabled me to work as a consultant. Also, lucky for me that I applied to the VA for medical care, because when the Bush administration took office, one of their first actions was instruct the VA to stop advertising medical benefits that was available for veterans. Subsequent actions by the Bush administration was to erect a series of roadblocks and hurdles to discourage veterans from applying for benefits. However, the Bush administration overplayed its hand when they proposed an annual $2,000 "membership" fee to apply for medical care. Of course this was patently unfair because one of the promises made to me when I joined the Army in January 27, 1960 was that I would have "lifetime medical care if necessary." The Bush administration was putting into practice the "starve the beast" theory. Basically the "starve the beast" theory is to cut taxes so much that then the government would have the excuse that their isn't enough money to support government programs like VA medical care. The political outcry was so great, that the Bush administration had to retreat from this proposal. However, they did lower the income eligibility of veterans applying for benefits. Thus, even less veterans could apply for benefits. My two brothers and several friends of mine who are veterans could not apply for benefits. Since I had already applied for benefits before the the Bush administration came into office, I was grandfathered into the system. I've had my share of bad breaks in my life but this is one of my good breaks. Not only do I have medical care but I have received the best medical care in my life. Ironically, all the years I had great medical coverage when I worked at my various banks, I only used it once. However, once I had my VA coverage, I had several medical issues. I had to have two operations. Various tests. I was worried about the quality of medical care. My worries were in vain. I have always received the absolute best medical care. Today was another example. As a followup to my kidney stone emergency this past January, the VA scheduled me for several tests. They have put me on medication to help avoid future kidney stones. They have tested me for my current condition. One of the things I really like about VA medical care is their preventive measures. Rather than waiting for something to happen, they take preventive measures. Also, their record keeping is excellent. My appointment this morning was at 9 A.M. The doctor saw me at 9 A.M. I didn't have to wait in a cubicle for an hour or more before the doctor quickly came in, looked at papers and mumbled something and leaving without even looking at me in the face or even talking to me. The doctor who saw me this morning sat down with me, looked at me and talked to me without being rushed. He carefully went over my records and shared this information with me. He gave me his sound and reasoned advice. I think the difference in doctors (VA versus private practice) is that the doctors in the VA don't operate on how many people they get in and out. In other words, they don't operate on volume. Of course the downside is that the VA is short of doctors. Many times I have been treated my nurse practitioners. Their care was also good but lacked the experience of a doctor. Another thing I enjoy about using the VA medical facilities is that I share a ride in the American Legion (Post 28) van with other veterans like myself. That makes a big difference. Instead of being shuttled off to a side office (like I was in private medical practice), which the doctor attended Mom and the Kids, I'm with a bunch of old geezers like myself. That means something to me. In fact, it means a lot to me. As a result of my tests this morning, the VA has scheduled me for a CT SCAN-RAD next month. I just hope I don't have to have my prostrate check again.

Clean Bill Of Health

This morning I got up early to catch the American Legion van (Post 28, the largest American Legion Post in the United States) to the Wilmington Veterans Administration Medical Center. I had a 9 AM appointment with the dermatologist. I didn't get much sleep last night because I worked at the Inn until 11 PM. I had to get up this morning around 4 AM to put myself together. One of the downsides of my retiring to Delaware is that I am quite a distance away from the nearest VA medical center. When I lived in Downingtown, I was 10 minutes away from the Coatesville VAMC. Fortunately for me though, the local American Legion Post 28 provides a van four times a week to transport us veterans to the Wilmington VAMC. Although I now have full insurance coverage through Medicare Part A and B and AARP supplemental insurance, I still use the VA for my medical care. Why? Because they take great care of me. Their focus is different. Unlike private medical care, the VA doesn't operate by how many patients they get in and out of their offices just to generate more income. Also, and this is a special pleasure I take, I don't have to wait in a waiting room with a bunch of squalling kids. Nothing against kids and family practices, but I've always felt that we old folk didn't get the same care a the youngest patients. Selfishly, I feel more comfortable with a bunch of old men (of which I am a charter member) than I do the moms and kids of family practices. The good news this morning was that I had my annual examination for skin cancer. Twenty years ago I had my first case of keratosis, which is a precancerous skin condition. On that fall day in 1988 I paid a visit to the Thomas Jefferson University Hospital in Philadelphia to check why my left cheek hurt every time I shaved in an upward direction. The doctor looked at my face and said immediately that I had a precancerous skin condition called keratosis. Of course when I heard the dreaded "C" word. I thought I would fall off of the doctor's paper covered table. Cancer. I thought my life was over. However, Dr. Uy soon explained to me that I had a precancerous condition that is probably the result of prolonged exposure to sun. Yep! That was me. A sun bather from way back. Now was the time to pay the price for all those years laying in the sun baking. To make a long story short, I had to undergo a painful topical chemotherapy treatment which removed the upper layer of skin from my face. Since then I've had to visit a dermatologists at least once a year to make sure the keratosis skin lesions have not return. Over the years I've had several instances of keratosis. The different dermatologists I've visited have removed these lesions by burning them off with dry ice. Painful? Yes (not as painful as that kidney stone I passed though.) All around me I have friends, including my Mother and brother, who have had more serious forms of skin cancer. So, you better believe that I see my dermatologist once a year at least. The problem when I moved down to Slower Lower Delaware (aka Sussex County, Delaware) was the lack of dermatologists. Surprising, since I live in a sea side resort community. But, that is the state of health care in this country. I even had trouble finding a general practitioner. I did find one but had to make an appointment many months in advance. So, this morning me and seven other veterans rolled up Route 1

to the Wilmington VAMC. Entering the main lobby, I headed towards the elevator and got off at the sixth floor of the building. I scanned my Veterans ID card in the machine in the dermatology unit. The Veterans Administration is very efficient in this manner. I went to the waiting room to await my 9 o'clock appointment. It wasn't too long until I was talking to my fellow veterans who were also waiting in the waiting room. Gentle banter was passed back and forth. I've always found at whatever VA waiting room I'm in, I easily make friends with the other veterans waiting for their appointments. Not so in a general practitioner's office. There, I'm just trying to stay out of the way of the screaming kids and demanding moms. It wasn't too long before the doctor appeared and asked me into their office. The doctor examined me and pronounced me clean. Big whoop! I made another year without a dangerous skin cancer problem. My next appointment is next September. Interesting fact, the dermatologist team that now services us veterans at the Wilmington VAMC are from the Thomas Jefferson University Hospital in Philadelphia. What goes round, comes round. Again, I am indeed fortunate. Another good day for Retired In Delaware.

Appointment Made

Good news today. The Wilmington VA called to arrange an appointment for me to see their dermatology department. My appointment will be in August, much earlier than the dates available to me from the two local dermatology offices that would make appointments for me. The other two local dermatology offices told me there weren't accepting new patients. The woman who talked to me today from the VA cared and listened to me. That's why I like using the VA. Once you get past the Bush Administration imposed roadblocks and hurdles to using the VA, I actually have gotten the best medical care in my life from the VA system. The people who work for the VA are not motivated by money as is most of the private medical sector. With the VA I receive preventive medical care. I feel relieved that my problem will be looked at by caring people. I felt myself slipping into depression. The phone call from the VA today reversed that slide. Today turned out to be a good day.

Emergency Room Visit

Bill motioned to me from across the backyard with his left arm to come to him. I put down the rose bush that I was transplanting and walked towards him over the thick mat of grass. As I got closer to him I saw he was holding his right arm. I asked “What?” He said that the neighbor’s dog had bitten him. He removed his hand and I could see the dog’s teeth puncture marks and blood on Bill’s arm. He said he was near the fence that divides our acre of backyard from our neighbor’s backyard. Our neighbor had put the fence in to keep his dogs in his backyard. He said he was standing by the fence when the neighbor's black Lab lunged at him and caught him by his sweater and sank his teeth into Bill's arm. Both Bill and I are veterans and use the Veterans Medical Association Center in Wilmington for our health care. The VAMC is located 93 miles from us. Bill called the local VAMC outpatient clinic in Georgetown, and they advised him to go to the emergency room at the VAMC in Wilmington or the closest hospital. We decided not to go to the closest hospital because Bill would be liable for the full cost of his emergency room visit. On January 3rd I passed a kidney stone. I didn’t know what was happening at that time. I called the VAMC and they advised me to go to their emergency room in Wilmington. I did not go because I thought I was near death. I went to the Beebe Hospital emergency room. They identified that I was passing a kidney stone and treated my condition in an efficient manner. Two weeks latter I received a bill for almost $4,000. The VAMC advised me that I would be liable for that bill because I “chose” to go to that emergency room. Eventually, the VAMC did pay 70% of the costs after a three month review. Knowing what happened when I visited a local emergency room, we didn’t want to go through that ordeal again. Thus, we took off this morning for the Wilmington VAMC emergency room. We arrived in Wilmington at approximately 10:45 AM. Then we proceeded to wait until 6:20 PM until Bill was finally treated for his wounds. Apparently, Bill, with his dog bite, was low man on the totem pole for emergency room procedure. He said that other patients arrived after he did and were considered more at risk and were given preferential treatment because of the seriousness of their condition. Finally, Bill asked the nurse practitioner if he could sign a release form without being treated. He told her “I’ll just go home and die.” Finally, this got their attention. Thus, almost 8 hours after arriving at the emergency room he was treated. The nurse cleaned his would. He was given a tetanus shot, and a prescription for antibiotics. We were both exhausted. This is another example of the abysmal state of health care in this county today. The VA care is great once you get treated. However, there is a shortage of doctors and accessibility to the VA facilities. Today was torture.