Sunday, June 29, 2014

Sunday Globe Special: Picking Up Where I Left Off

Not what and where I had intended to start, but the blog demands its own fluidity and it is beyond my control....

"VA falls short on medical care of servicewomen; Problems abound with lack of staff, delays of key tests" by Garance Burke | Associated Press   June 23, 2014

SAN FRANCISCO — Already pilloried for long wait times for medical appointments, the beleaguered Department of Veterans Affairs has fallen short of another commitment: attending to the needs of the rising ranks of female veterans returning from Iraq and Afghanistan, many of them of child-bearing age.

Yup, the poor, start-wars-based-on-lies government. 

And you wonder why I'm sick of this sh**?

Even the head of the VA’s office of women’s health acknowledges that persistent shortcomings remain in caring for the 390,000 female veterans seen last year at its hospitals and clinics — despite an investment of more than $1.3 billion since 2008, including the training of hundreds of medical professionals in the fundamentals of treating the female body.

According to an Associated Press review of VA internal documents, inspector general reports, and interviews:

■ Nationwide, nearly one in four VA hospitals does not have a full-time gynecologist on staff....

■ When community-based clinics refer veterans to a nearby university or other private medical facility to be screened for breast cancer, more than half the time mammogram results are not provided to patients within two weeks, as required under VA policy.

See: The Boston Globe is My Heart and Lungs

■ Female veterans have been placed on the VA’s Electronic Wait List at a higher rate than male veterans....

■ And according to a VA presentation last year, female veterans of child-bearing age were far more likely to be given medications that can cause birth defects than were women being treated through a private HMO.

Cover story for the birth defects related to depleted uranium?

‘‘Are there problems? Yes,’’ said Dr. Patricia Hayes, the VA’s chief consultant for women’s health, in an interview. ‘‘The good news for our health care system is that as the number of women increases dramatically, we are going to continue to be able to adjust to these circumstances quickly.’’

Someone should send her to the psychiatrist's office!

The 5.3 million male veterans who used the VA system in fiscal year 2013 far outnumbered female patients, but the number of women receiving care at VA has more than doubled since 2000.

And truthfully, despite the misguided values of the extreme feminists, that is a sign that the U.S. is losing the wars. The more life-giving women we throw into life-taking wars signals failure. Only losing sides do that.

The tens of thousands of predominantly young, female veterans returning home has dramatically changed the VA’s patient load, and the system has yet to fully catch up. Also, as the total veteran population continues to decrease, the female veteran population has been increasing year after year, according to a 2013 VA report.

All enrolled veterans can use what the VA describes as its ‘‘comprehensive medical benefits package,’’ though certain benefits may vary by individual and ailment, just like for medical care outside the VA system. The VA typically covers all female-specific medical needs, aside from abortions and in-vitro fertilization.

The strategic initiatives, which sprang from recommendations issued six years ago to enhance women’s health system-wide, have kick-started research about female veterans’ experience of sexual harassment, assault, or rape in a military setting; established working groups about how to build prosthetics for female soldiers; and led to installation of women’s restrooms at the more than 1,000 VA facilities.

That rape crisis sure faded away real quick.

Yet enduring problems with the delivery of care for women veterans are surfacing now amid the growing criticism of the VA’s handling of patient care nationwide and allegations of misconduct, lengthy wait times, and, potentially, unnecessary deaths.

And they will be submerged again soon.

Used to treating the men who served in Vietnam, Korea, or World War II, many of the VA’s practitioners until a few years ago were unaccustomed to giving advice about birth control or treating menopause.

The study on distribution of prescription medication that could cause birth defects is illustrative of the lagging awareness; one of every two women veterans has received medication from a VA pharmacy that could cause birth defects, compared to one in every six women who received care through a private health care system, said the study’s author, Eleanor Bimla Schwarz, a senior medical expert on reproductive health with VA.

Schwarz, who also directs women’s health research at the University of Pittsburgh, said many new female veterans are of child-bearing age, a higher percentage are on medication than in the general population, and the majority of these women are not on contraception.

Hayes said the VA seeks to place a designated women’s provider in every facility and expects to install a ‘‘one-stop’’ health care model that allows women to go to one provider for a range of services, including annual physicals, mental health services, gynecological care, and mammograms.

So Obummercare already had a roll out before the October failure?

Until that happens, however, some VA clinics have limited gender-specific treatments.

Many female veterans report having to drive hours to get care, while some of them tell of struggling to get the VA to pick up the tab for a private doctor.

Army Sergeant LaQuisha Gallmon of Greenville, S.C., whose daughter was born two months ago, said she had been authorized to see a private physician for prenatal visits and delivery. But because the paperwork hadn’t been fully processed when she went to an outside emergency room for complications in pregnancy, VA has refused to pay the $700 bill, she said.

It IS OBUMMERCARE!

‘‘I called the VA women’s clinic and they told me everything was approved for me to get outside care,’’ said Gallmon, 32, who served six years in Iraq, Germany, and Fort Gordon, Ga. ‘‘I wound up in the ER for complications, and a week later I received the letter saying they wouldn’t pay for it.’’

We got a letter here, too.

--more--"

It was a literal connection that put me on this course:

"Pattern of errors, sporadic review in military hospitals; Documents show most mistakes in maternity, surgery" by Sharon LaFraniere and Andrew W. Lehren | New York Times   June 29, 2014

FORT SILL, Okla. — Jessica Zeppa, five months pregnant, the wife of a soldier, showed up four times at Reynolds Army Community Hospital here in pain, weak, barely able to swallow, and fighting a fever. The last time, she declared that she was not leaving until she could get warm.

Without reviewing her file, nurses sent her home anyway, in a wheelchair, with an appointment to see an oral surgeon to extract her wisdom teeth.

You know, honestly, I would not make the appointment for that with the VA.

Zeppa returned the next day, in an ambulance. She was airlifted to a civilian hospital, where despite relentless efforts to save her and her baby, she suffered a miscarriage and died Oct. 22, 2010, of complications from severe sepsis, a bodywide infection.

It's negligent homicide if not murder.

Medical experts hired by her family said later that because she was young and otherwise healthy, she most likely would have survived had the medical staff at Reynolds properly diagnosed and treated her.

Where's my bonus and are you done phoning up those logs yet?

“She was 21 years old,” her mother, Shelley Amonett, said. “They let this happen. This is what I want to know: Why did they let it slip? Why?”

You don't really want to know.

The hospital doesn’t know, either.

Uh-huh.

Since 2001, the Defense Department has required military hospitals to conduct safety investigations when patients unexpectedly die or suffer severe injury. The object is to expose and fix systemic errors, often in the most routine procedures, that can have disastrous consequences for the quality of care. Yet there is no evidence of such an inquiry into Zeppa’s death.

You know, it is such on odd thing. 

The propaganda $y$tem that has been set up in this country through its -- sorry to spell it out as such, but let's be honest-- ejewkhazional $y$tems and ma$$ media has the average citizens believing the people who lied troops into war care about them the most as the back-end of the compact has been egregiously violated, while casting those who vociferously opposed all of this that led to such things as antiwar traitors and such, something that continues to this day. 

When you step back and see the absurd and surreal insanity you reach the point I am out now after eight years. Out comes the white flag, let those liars destroy themselves, hopefully they won't take the rest of us with them, maybe my fellow citizens will execute a few for good measure to send a signal to the next would-be and wannabe crop waiting in the wings, and ride this f***er out. 

Hope to see you in the next phase, folks.

The Zeppa case is emblematic of persistent lapses in protecting patients that emerged from an examination by The New York Times of the nation’s military hospitals, the hub of a sprawling medical network — entirely separate from the scandal-plagued veterans system — that cares for the 1.6 million active-duty service members and their families.

Not symbolic?

Internal documents obtained by The Times depict a system in which scrutiny is sporadic and avoidable errors are chronic.

And I wanted single-payer from this government. Ha!

As in the Zeppa case, records indicate that the mandated safety investigations often go undone: From 2011 to 2013, medical workers reported 239 unexpected deaths, but only 100 inquiries were forwarded to the Pentagon’s patient-safety center, where analysts recommend how to improve care. Cases involving permanent harm often remained unexamined as well.

Ah, I'm.... (blog editor just gritting and growling)

At the same time, by several measures considered crucial barometers of patient safety, the military system has consistently had higher than expected rates of harm and complications in two central parts of its business — maternity care and surgery.

More than 50,000 babies are born at military hospitals each year, and they are twice as likely to be injured during delivery as newborns nationwide, the most recent statistics show. And their mothers were more likely to hemorrhage after childbirth than mothers at civilian hospitals, according to a 2012 analysis conducted for the Pentagon.

In surgery, half of the system’s 16 largest hospitals had higher than expected rates of complications over a recent 12-month period, the American College of Surgeons found last year. Four of the busiest hospitals have performed poorly on that metric year after year.

Little known beyond the confines of the military community, the Pentagon’s medical system has recently been in the spotlight. In late May, Defense Secretary Chuck Hagel ordered a review of all military hospitals, saying he wanted to determine if they had the same problems that have shaken the veterans system.

Why did the war-promoting media suddenly pick up this focus anyway? 

Could it be to get scarce resources poured into another avenue of the military machine now that (we are told anyway) the wars are winding down? 

Is it just to keep reconditioning and manipulating the mind to keep us in a military mindset and war mentality? 

Is it in preparation for larger events still to come when we will all have to support the troops again? 

Since when has the New York Times -- the leading liar into Iraq with a front-page bullhorn bylined Judith Miller -- had our best interests at heart?

Hagel said the review would study not just access to treatment, the focus of investigations at the veterans hospitals, but also quality of care and patient safety — issues that the Times has been looking at, and asking the Pentagon about, for months.

Defense Department health officials say their hospitals deliver treatment that is as good as or better than civilian care, while giving military doctors and nurses the experience they may one day need on the battlefield. In interviews, they described their patient-safety system as evolving but robust, even if regulations are not always followed to the letter.

“We strive to be a perfect system, but we are not a perfect system, and we know it,” said Dr. Jonathan Woodson, assistant secretary of defense for health affairs. He added, “We must learn from our mistakes and take corrective actions to prevent them from reoccurring.”

Honestly, I can't read or comment on this rote and pat responses from the government playbook anymore because they are f***ing outrageous. They need to shut their mouths and not say anything rather than opening them and let spew come out. Just shut up!

Avoidable errors can and do occur at the best of hospitals. But the military’s reports show a steady stream of the sort of mistakes that patient-safety programs are designed to prevent.

The most common errors are strikingly prosaic — the unread file, the unheeded distress call, the doctor on one floor not talking to the doctor on another. But there are also these, sprinkled through the Pentagon’s 2011 and 2012 patient-safety reports:

■ A viable fetus died after a surgeon operated on the wrong part of the mother’s body.

■ A 41-year-old woman’s healthy thyroid gland was removed because someone else’s biopsy result had been recorded on her chart.

■ A 54-year-old retired officer suffered acute kidney failure and permanent hearing loss after an incorrect dose of chemotherapy.

Malpractice suits can also be a rough indicator of risk. From 2006 to 2010, the government paid an annual average of more than $100 million in malpractice claims from surgical, maternity and neonatal care, records show.

Okay, in THIS CASE it is the TAXPAYER FOOTING the BILL for GOVERNMENT MALFEASANCE when SO MANY OF US were AGAINST EVERYTHING THAT LED TO THIS! 

And yet we (the collective we, as in will of the people) are still not listened to, still disparaged and denigrated, and still insulted!

It would be paying far more if not for one salient reality of military health care: Active-duty service members are required to use military hospitals and clinics, but unlike the other patients, they may not sue. If they could, the Congressional Budget Office estimated in 2010, the military’s paid claims would triple.

Just to make something clear, in addition to ending the empire and bringing the boys home, the vet's medical care is my first "defense" priority when creating a budget. Screw the weapons procurement and surveillance state $hit. 

There are promises to keep, right?

--more--"

And then there is this front-page feature going back into the jungle over what is not called a massive war crime due to the use of chemical weapons:

"Plagued by diseases, aging fliers find VA unwilling to help; They didn’t drop Agent Orange, but they flew those contaminated planes on hundreds of domestic missions" by Bryan Bender | Globe Staff   June 29, 2014

WASHINGTON — For more than a decade, Richard Matte has suffered through a series of grave illnesses. The 70-year-old from Chicopee has a transplanted heart. He’s been treated for bladder cancer, lung cancer, and nerve disorders.

But it wasn’t until 2011 that the retired master sergeant learned he and fellow veterans of the Air Force Reserve’s 731st Tactical Airlift Squadron in Westover might have been exposed to traces of Agent Orange. Matte quickly looked up ailments designated by the Department of Veterans Affairs as linked to contact with the deadly herbicide.

“I'm sitting here thinking, ‘Jeez, I got about 10 of these myself,’ ” Matte, who recently had his left leg amputated, recalled in an interview.

I'm heartbroken, I'm throwing my hands up in the air, I don't know what to type, nothing to type anymore.

But unlike hundreds of thousands of other veterans who have been compensated by the VA for Agent Orange exposure during the Vietnam War, Matte never served in Southeast Asia or directly handled the deadly substance. The C-123 Provider cargo planes he crewed had been used to dump thousands of canisters of the toxin over Vietnam, before being brought home to Westover and used for domestic missions from 1972 to 1982.

It turns out those old planes were contaminated with toxic residue. Once they were retired for good, the Air Force even cordoned them off at a remote desert airstrip in Arizona and treated them as hazardous waste. 

See: Victims of Vietnam 

Also see this: Vietnamese Seeing Red Over Agent Orange 

Napalm burns are a separate matter.

Despite growing evidence that the fliers were exposed to the poison, the VA is denying claims made by Matte and other veterans from the 731st Tactical Airlift Squadron, saying they are not eligible for special Agent Orange-related benefits mandated by Congress — health care as well as disability and survivor benefits. 

Hopefully, by the time they agree you will all have died. $eems to be the attitude.

Now when do you want to make that appointment?

The VA is sticking to its long-held position that the exposure to Agent Orange by these veterans was “minimal.” It asserts that “it is unlikely that sufficient amounts of dried Agent Orange residue could have entered the body to have caused harm.”

Yup, that's their story and their sticking' to it! 

And don't you dare mention the dreaded depleted uranium!

Pleas for help from Matte and other veterans in his situation have garnered press coverage over the years. But pressure has been mounting on the VA as more public health agencies, toxicology experts, and private physicians weigh in on their behalf, asserting that their illnesses could be the result of exposure to Agent Orange.

They have suddenly been discovered, and not a moment too soon!

The C-123 Veterans Association says it knows of up to 50 Massachusetts residents — or their survivors — who are in the same predicament as Matte.

The federal Centers for Disease Control and Prevention said last year, based on new analysis of swipes taken from several of the planes in the 1990s and shortly before they were disposed of in 2010, that the planes clearly contained a toxic residue, and crew members had a “200-fold cancer risk.” 

Didn't they just "lose" a bunch of anthrax?

In April, a team of medical researchers that included public health experts from New York and Boston concluded that “the potential for dioxin exposure to personnel working in the aircraft post-Vietnam is greater than previously believed and that inhalation, ingestion, and skin absorption were likely to have occurred during post-Vietnam use of the aircraft by aircrew and maintenance staff.”

The findings, published in the journal Environmental Research and sponsored in part by the Air Force School of Aerospace Medicine, “contrast with Air Force and VA conclusions and policies,” wrote Jeanne Mager Stellman, professor emerita at the Mailman School of Public Health at Columbia University.

We know who wins that fight.

The reports have persuaded Representative Richard Neal, a Democrat from Springfield who represents many of the afflicted veterans, that the Pentagon and VA have to adopt a different approach to these claims.

“Taking into account this information and the high levels of illnesses known to be linked to Agent Orange occurring in these Westover veterans, I believe these men and women are entitled to the same benefits granted to those who served on the ground in Vietnam,” Neal wrote earlier this month to the Department of Veterans Affairs.

What I hope, and I know it is silly because it's always the same story, vets camped out in D.C. because they didn't get paid after WWI, but what I hope is these guys and gals of today are not waiting 40+ years to have their concerns and issues addressed in such vague fashion. I know it's "progress," but....

In a statement, a VA spokeswoman, Meagan Lutz, said the agency “wants to ensure that all veterans, including those who served on C-123s, receive the benefits to which they are entitled under the law. VA will continue to review new scientific information on this issue as it becomes available.”

That's a $TALLING TACTIC!

But the Air Force’s own handling of the planes shows it believed the aircraft posed a health hazard.

Records released under the Freedom of Information Act in 2011 revealed the Air Force confirmed the planes were contaminated by “herbicide residue” in 1979, following complaints of maintenance personnel.

A sampling found residue of the dioxin in Agent Orange and concluded that “it may ultimately be necessary to completely deodorize the aircraft.”

One of the planes was tested a decade and a half later — in 1994 — before being placed in an Air Force museum in Ohio and was similarly found to be contaminated.

Beginning in 1998, the Air Force kept the planes in quarantine at an Arizona base and decided in 2009 not to sell the aircraft or parts, citing “Agent Orange contamination during the Vietnam War.”

That is yet another source of consternation to the C-123 veterans.

“My colleagues who flew the C-123 with me and worked on the C-123s are not afforded the benefit of VA recognition, notwithstanding the fact they are coming down with the same illnesses,” said retired Colonel Archer Battista, 68, of Belchertown, Mass., who piloted the C-123s at Westover for nearly 25 years and is trying to raise awareness about their plight.

Battista, himself a prostate cancer survivor, is one of the only C-123 veterans who are eligible for Agent Orange-related benefits — but that is because unlike most of the others he served on active-duty in Vietnam before he joined the reserve unit at Westover.

“For me it is really a moral quest,” said Battista, who is also a lawyer. “I think VA is wrong, dead wrong in the position it has taken.’’

“I know guys and gals I flew with — good friends — ought to be entitled to the same,’’ he said. “This is a fight for our friends and we think it is a very important one.”

The VA has designated as service-related more than a dozen diseases — including certain heart ailments, forms of diabetes, cancer, leukemia, Parkinson’s disease, as well as birth defects in their children — for those who were exposed to Agent Orange on the battlefield or handled it as part of their duties between 1962 and 1975.

According to the Congressional Research Service, some 600,000 veterans of the Vietnam era have participated in the VA’s so-called Agent Orange Registry that makes them eligible for an examination, a series of laboratory tests and, if approved, a range of benefits.

At least 10 Westover veterans have applied for Agent Orange benefits and have been denied, said retired Major Wes Carter of Andover, a former pilot who heads the C-123 Veterans Association.

The only exception was retired Lieutenant Colonel Paul Bailey of Bath, N.H., but his benefits were approved only at the 11th hour.

Sufffering from prostate cancer that he believed was due to dioxin exposure during his service in the 731st, he sought VA health benefits in 2011. After nearly two years he was informed he was being denied.

After his case received some media attention and congressional scrutiny, the VA changed its position, making him the only post-Vietnam C-123 veteran to be eligible for Agent Orange benefits.

Why can't they do the right thing fir$t in$tead of la$.... never mind.

“He died a few months later,” says his widow Nancy Bailey, 65. “It was too late. It would have been nice if they had not denied his claim when he first got sick.”

But because of the benefits he was ultimately approved for, she says, she is receiving a special survivor benefit in the form of $1,250 non-taxable income each month.

Deserves every bit of it, too. That's not even that much.

“I guess I shouldn’t complain because he is the only one who they have given the claim to,” she said. “But I am very concerned about all the other veterans. The VA is really fighting hard.”

Like other veterans and their families, she believes there was a “big coverup’’ about how contaminated the planes really were. 

Okay, now you a veering off into conspiracy fantasyland because if we have learned nothing else over these last eight years it is that the U.S. government never, and I mean never(!), covers things up. 

Maybe some of that Agent Orange got on her!

Many believe they never should have been operated at all following what was known as Operation Ranch Hand, the military operation between 1962 and 1971 that sprayed an estimated 20 million gallons of herbicide over Vietnam to deprive the communist Vietcong of food and vegetation cover.

Yeah, and it destroyed everything else as well as making life unlivable for the local populations.

Then you wonder why they were VC?

Now the VA has commissioned its own independent study on their potential exposure. The study, underway at the National Academy of Sciences, is slated to be completed in September.

Pffft!

The veterans express deep frustration that they will have to wait longer for the VA to make a new determination.

It's like trying to make an appointment!

“The rest of the federal government disagrees with VA and has concluded C-123 veterans were exposed,” said Carter. “How many more expert opinions will it take?”

Matte, for his part, says he has given up trying to seek compensation for Agent Orange exposure.

“They can bury you under a mountain of paperwork and it never seems to be enough.”

I know how he feels looking at the stack of unread and half-read Globes that is starting to build again.

Also lost in all this is the current round of U.S. chemical warfare on the planet, be it herbicides in the never-ending drug war or the use of white phosphorous in Afghanistan and Iraq, as well as Israel's use of it in Lebanon and and against Palestinians in Gaza. 

No disrespect to vets intended.

--more--"

Some get it half right, but that's not good enough anymore. 

Related: Obama Abandoned Veterans 

Again?

Also see:

N.H. Marine killed in Afghanistan

He found his calling and loved what he was doing. Then he was called home.

Thousands line N.H. roads as fallen Marine comes home
Nashua man’s valor marked by Medal of Honor
A Lowell native’s Medal of Honor
Obama presents Medal of Honor to Afghanistan veteran
Retired Army sergeant awarded Medal of Honor for Afghanistan service

Has, from what I've seen from Hollywood, the feel of Germany, 1944. 

I'm not saying the soldier not worthy or anything, I'm just saying awarding lots of medals about the time they were losing the war. It's a public relations pick-you-up for war is all. Soldier is deserving; criminal awarding the medal something else.

Globe was very, very late today and I had to drive around and around town to get one. WTF? Is that helping with the greenhouse gas problem, making me do that?