Wilmington VAMC Visit

The Wilmington VAMC December 19, 2011

Yesterday morning I visited the Wilmington Veterans Affairs Medical Center.  I had a lot on my plate to accomplish during my morning visit.  I had to coordinate the following:

• Blood work
• Dermatology
• Sign up for MyHealthevet
• Swollen leg and ankle issues

I get the best care I've ever had in my life through the VA system.  The only problem is that the main medical facility is 82 miles away from me.  The American Legion Post 28 out of Millsboro, Delaware provides a van to ferry us old vets to the Wilmington VA Mondays through Thursday.  The only catch is that we have to finish all of our appointments by 11 am so all us Old Vets can catch the van back to Sussex County, at the very end of Delaware.  Wilmington is at the top of Delaware.  Delaware as you all know is a peninsula.  We're a little like Korea, just a jut of land sticking out in the Atlantic Ocean and Chesapeake Bay.

My trip from Point A to point B yesterday 

I was dreading this trip because I didn't think I could coordinate everything and see everyone.  I especially wanted to see my doctor (I finally have a doctor who CARES about me) to address the problem of my swollen lower legs and ankles.  When I called earlier int he week the earliest I could make an appointment with him was 1 o'clock in the afternoon, and that would have been too late.  He suggested I do a "Walk In" and take my chances.

So that was the challenge I was faced with yesterday.  Without going into the boring logistics I will tell you that I was successful!  To do the "Walk-In" I had to go to the Emergency Room.  They saw me immediately.  The nurse practitioner looked at my legs and ankles and filled out the required Sheet of Paper that I was to take to Team B.  The Sheet of Paper is required to gain entry.  

Waiting for the doctor to check my ankles, that my records on the computer 

While I was waiting my turn for give blood for my blood work I took the elevator to the sixth floor and the Dermatology unit and was taken care of in a timely manner again.  The Wilmington VA has residents and doctors from Thomas Jefferson University of Philadelphia to make the daily trip from Philadelphia to Wilmington to take care of us Old Vets.  Coincidentally when I was first diagnosed with a pre skin cancer condition twenty-five years ago it was from a doctor at Thomas Jefferson University in Philadelphia.  At that time I worked at a bank just up the street.  Yesterday the resident found five spots on my face and he burned them off.  Didn't feel good but at least I'm keeping the skin cancer at bay.

I would rather be shopping

Then back down to the first floor to have my blood drawn.  Then to wait for another doctor to look at my legs.  He determined that I should wear special support socks to keep my lower legs from swelling when I stand a lot, which is what I do when I work at the hotel like I am all these week.  He also increased the size of my "water pill" prescription.  

I arrived at the VA at 7:30 am.  I was done with all my business at 10 am and coincidentally the van driver was ready to go.  Perfect timing!

Bill picked me up at the Rt. 1 and 5 pickup point for the VA van and while he was driving me home my doctor called me and discussed my situation, including my upcoming biopsy for prostate cancer.  While I am not looking forward to this biopsy (I'm looking for any excuse to get out of it), I did feel more comfortable talking to a medical professional he seems to care about ME.

It's ironic but my whole life I've never felt I had a doctor who cared about ME.  Never.  In fact I had a doctor who almost caused my death by his negligence and other doctors who seems only interested in Turnover.  What I like at the VA medical system is that the people who work there are not in it for the money.  Most of them seem to work there because they truly care about us Old Vets.  At the VA they don't put you in a cubicle to wait for them because they're trying to get as much turnover as possible to make as much money as they can.  There is a difference.  

I don't have a whole lot longer to go in this world but I do feel comfortable knowing that where I go they do care about me.  That is as long as this government keeps the Republicans out of power.  Once they're in, they will try and do away with the VA medical system and privatize it.  If that happens, then I am a goner.  If anyone ever wanted to know why this lifelong conservative Republican is a liberal Democrat, one need to look no further than when George W. Bush and Company attempted to do away with medical care for veterans like me by charging an annual $2,500 FEE for us to use the VA.  Pardon me while I get on my political stump again but I seem to remember so clearly when I joined the Army, one of the reasons given to me to join by the Army recruiter was that I could have a FREE college education (which I took advantage of) and Lifetime Medical Care IF I NEEDED IT. 

 Well, there came a time in my life when I was without a job (2000) and had to have TWO MAJOR SURGERIES.  The VA performed those surgeries and saved me.  Bill had a ruptured gall bladder.  They took him by ambulance to Philadelphia in the driving snow and SAVED HIS LIFE.  Bill was in Intensive Care for FOUR DAYS.  They didn't think he would make it.  He did and I attribute that to the excellent non-profit motive driven care that he received from the Philadelphia Veterans Administration Medical Center.  My former dentist's wife had a similar situation where the VA saved her life.  

So when anyone asks me "How can you be ONE OF THOSE LIBERAL DEMOCRATS?" all I can answer is that the VA benefits that I EARNED (just like Social Security that I PAID INTO) saved my life  as well as saving Bill's life when he gall bladder burst during a snowstorm.  If the Republicans were in power and had their way both Bill and I would probably be dead or if we did survive we would be so deep in debt life wouldn't be worth living.  

So there my Republican Friends, chew on that reality.  And by the way, Merry Christmas and Happy New Year!

The beautiful 2 ft by 3 ft watercolor (original) in the VA emergency waiting room
I WANT IT!

Arm Injury Update

Bill waiting for me this morning at the boardwalk in Rehoboth Beach

This morning for the first time in almost two weeks, I walked the boardwalk.


Bill took me down.  I still don't feel comfortable driving with my arm that I injured in a fall two weeks ago.  


The only time I've driven since my fall on Sunday, October 17th, was last Sunday when I took a short drive down Oyster Rocks Road.  My arm was still stiff but I was able to drive.  However, I still didn't feel comfortable driving on Rt. 1 so Bill drove me to work this past Wednesday.


I"m scheduled to work tonight and tomorrow night.  I'm going to drive myself.  I have to start sometime.


This week on Tuesday I'm scheduled to see the orthopedic doctor.  I am upset that it will have taken me two weeks from the time of my X-ray until I see the doctor for his analysis of the X-ray.


Hindsight is 20-20 so now I know the next time (which I hope there never is) I fall and injure a limb, I will go directly to the emergency room.  


I thought I was doing the right thing by going to my doctor but apparently this is not the way things are done in the private health care system.  What I should have really done was gone to the VA.  They have always taken good care of me.  


The VA is not a for profit system.  They operate differently.  They see their patients and take care of them immediately.  


It is very obvious from my experience since my fall that the private health care system is inferior to the VA.  Their first priority is to generate a profit.  The care of the patient is obviously secondary.  


I learned my lesson.  I won't make that mistake again.  

The Madness Continues

The injured hand

So I go to the Orthopedics Associates for my appointment today at 2:20.  They tell me it is for NEXT TUESDAY, November 2nd.  That would be Election Day.


I am going to see Dr. Otter to go over the results an X-ray I had taken of my injured arm on October 19th, or my fall on October 17th.  TWO WEEKS LATER.


Then I have to go back to my original doctor for what I don't know.  I stopped there on the way back and asked why.  Sandi, the person in the office said "Well, not unless you want to.  We really can't do anything for you. Dr. Otter has the facilities to read the X-ray, we don't."  


You know what I'm thinking?  I'm thinking I would have done just as well to see a doctor when I was at the VA yesterday.  All this talk about a Single Payer System and government takeover of health care....I'll tell you one thing right now.  I get the BEST HEALTH CARE from the VA without all this bullshit.


So I'm using my private health care for an arm injury.  First I go to my doctor.  She sends me to Beebe Medical Campus to get an X-ray.  Then I have to go to the Orthopedic Unit to have the X-ray read.  Then I have to go back to the doctor.  I'M WAITING TWO WEEKS TO HAVE MY X-RAY READ.  Does that make ANY SENSE?  


In the meantime, my supplemental insurance has risen from $117.32 to $136.56 in a little over a year.  It was $117, then $120, then $126, then $130, now it's $136.  I also pay over a $100 a month for Medicare Part B.  So what am I getting for my money?  Basically insurance for an emergency room visit.  I'm not getting timely medical care.  


Last year I tried to see a dermatologist through my private insurance.  This was in May.  I was told the earliest I could get an appointment was DECEMBER!   That's when I decided to go back to the VA even though it requires a trip on the American Legion Van to the 89 miles to the Wilmington VAMC.  I saw the dermatologist yesterday at the VA.  They are from Thomas Jefferson University.  One of the top hospitals in the country for dermatology.  


If the Republicans get in power and have their way they will privatize the VA.  Then everything will be screwed up.  EVERYTHING.  


I'm glad I'm old and I won't have to put up with this crap much longer.  


What a joke.

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.