Our initial contact with them (other than my husband applying for care at our local VA office) was when we had to take him in to get the wheels rolling so he could get immediate care for his diabetes, which was beginning to dangerously wear him down. Granted, that first contact was with the American Legion officer, but he also was a Veteran, as well as our friend who helped us get to the right people. The American Legion officer was very caring, treating my husband and I with the utmost respect and compassion. Within days, our appointments started to get him stabilized.
At the beginning, we had a small co-pay for his medicines, but no charge for the visits to the hospital/clinics because at that time, there were no service-connected issues. This was something we could handle, as it was less of a cost than what we had been paying for his medications in the private sector. This was a huge weight off our shoulders.
We were assigned a primary care physician. This is one area of VA care that we were not very satisfied with. Of all the experiences we've had with the VA, it is one that wasn't up to par. We never could quite connect, because there was no effort on the part of the doctor to visit or learn much about what was going on. Most of the time was spent during a visit with him putting data into the system, which gave us the impression he wasn't really listening to my husband or caring about my husband and whatever issue we were there for. There would then be a referral to someone else or changing something on a medication. Throughout the entire time we were under that care of that doctor, we never felt comfortable. Fortunately, we've just recently gotten another primary physician and have immediately established a rapport. We thank God for this blessing.
Initially, many tests were administered and specialty clinics visited in order to get an overall health analysis for my husband. They didn't just focus on the diabetes, but his general health. It was a bit overwhelming, especially since we didn't know any of the doctors and didn't know our way around the hospital/clinics. From the very beginning, we were struck at how caring, respectful and kind everyone was ~ from the youngest assistant to the more experienced doctors. Another aspect we were awed by was the friendliness and helpfulness of other patients who were willing to offer suggestions and shared experiences, steered us in the right direction and generally made us feel comfortable being there. This is something that I've always made a point of paying back when we visit the facilities.
From that point on his care was monitored with upcoming appointments for each issue they felt needed attention. A class on what diabetes is and how to live with it was one of the first steps. Unfortunately, the diabetes specialist was in another facility than the one we were assigned, but the availability of buses that took veterans to various other hospitals, clinics and facilities helped a lot. Still, it was an all-day event. Follow-up didn't turn out to be what we had hoped, due to the fact that the regional VA hospital hadn't been assigned a diabetic specialist and wouldn't have one for many years. I did feel that this was one area where the VA needed improvement, as there were many people in my husband's generation, particularly Vietnam veterans, who had developed Type II diabetes. I learned that there were more Vietnam veterans who had Type II than the general population. It was this fact that prompted the VA to make the determination that it was service-related from being in theater in Vietnam because of the spraying of Agent Orange. At that point in time, benefits were increased to reflect this service-related condition.
All in all, the class was very informative and we were well armed with much information about how to deal with diabetes. Over the next several years, we only saw the diabetic specialist a few times. Treatment was still oral medication and monitoring the blood sugars. So we floated along without really having any idea about how well or bad things were going, due to the fact that VA didn't have anyone to follow-up with us. Howvever, in the meantime, VA kept up with his general health with periodic appointments at various clinics to offer care, further medications and/or minor surgeries.
As is the progression of diabetes, there came a time that the oral medications weren't enough and insulin was recommended. In the last year, the regional hospital put on it's staff a full-time diabetic specialist. He was very helpful in getting my husband onto a better program of insulin, and usage of the insulin, that has resulted in more controlled blood sugars which have helped him tremendously in his health and with the kidney disease. When we first visited with the specialist, he was very informative, friendly and helpful. He would call my husband frequently to get all his readings and then make adjustments with his dosages. We were very grateful and relieved that we finally were getting some assistance on this, because over the years, we felt that the issue of the diabetes was something that wasn't being addressed very well. That was totally turned around with this new specialist. We now know that if there is an issue and it is necessary to have assistance with this aspect of my husband's health, there will be immediate help.
A side effect, if you will, of diabetes is kidney disease. We were assigned to the Renal Clinic and had a wonderful doctor and nutritionist. During this stage of my husband's health, we never felt that we were left drifting or not knowing where to turn or how to get help. Frequent monitoring and adjustments to medications and diet were made throughout the several years of this stage. We had a couple of renal doctors during this time and the one we had the longest would often call us after hours with lab results to talk over what they meant and how to adjust things, if necessary. The nutritionist, as well, would call us after the labs to assist me in any dietary needs to help with diabetes control. My husband stayed pretty level for about 4 years and then the time came to make some major decisions.
VA signed us up for a class to learn about all options available for the time when it would become necessary to either have a kidney transplant or go on dialysis. This was a day-long class that was very informative. We learned that our regional facility has the shortest wait for transplants in the nation, usually within 2 years. So it was a large group with folks coming from several states in our region. It gave us a lot to consider for the next step that would be a major life-changing choice.
One of the first steps was a surgery for a fistula. This is to allow for hemodialysis should it be necessary in an emergency or if my husband opted for peritoneal dialysis and it wasn't working. It required two veins to be connected in his wrist. As time would go on, these veins would expand, making a portal for the dialysis treatment. As with any surgery he's had, the care and treatment he got before and after was outstanding. This surgery was done well in advance of the time he needed to have dialysis in order for it to "cure".
My husband thought he would opt for a transplant, so VA sent us to a home dialysis clinic that partners with the VA for further instruction. This was a week-long preliminary training course to learn everything about transplantation and dialysis. To say it was a huge learning curve is an understatement! Very overwhelming. But we persevered and discussed and discussed some more. The wheels had started turning toward getting on the transplant list.
This involved a battery of tests, both physical and mental that the VA conducted. Another week or so of appointments, tests and visiting with various specialists. No rock was left unturned. A dental exam was also necessary. There can be no health issues, such as infected teeth, to stand in the way of the transplant procedure. After that was all through, we waited to learn the results.
About the time we learned he had been approved "nationally" for the transplant and were contacted for updating on the testing, we had a hard decision to make. I asked my husband to really read over the information that was given to us about all that was involved with transplantation: the long hospital recovery (he thought it would just be about a week or so ~ it's 4-6 weeks!), the follow-up labs several times a week to watch for rejection, then labs/appointments every week, eventually slowing to once a month, the double-handful of anti-rejection and supporting medications necessary to take, what is necessary for caregiving, etc. and the fact that the first 6 months are critical; if you can get past that, chances are pretty good that there won't be rejection, but there is still that chance, even up to and after a year. During all that time, many labs, appointments and testings are necessary.
After realizing what it truly entailed, he opted not to have the procedure. A large part of that decision was based on his age and other health issues, which wouldn't assure him any more longevity than dialysis. When he informed VA about his decision, they were so nice and understanding. They respected his decision and told him that if he should change his mind, they would be happy to start the procedure again to offer him that option. We were very appreciative of their understanding and support in this matter.
VA has been very good about contacting us in plenty of time for each appointment. They give a printed sheet at the time an appointment is made for either further treatment, another clinic appointment and/or follow-up, which you can take home for handy reference. Then, within a week or so, another notice comes in the mail. As well, about a couple of weeks prior to the appointment, a card will arrive with similar information. Then, a day or so before the appointment an automated phone call comes as a reminder. You can also call and get any and all appointments.
Since my husband has been enrolled as a patient, a new tool has been added: My HealtheVet. This is an online program where you can keep your health records, keep track of appointments, refill prescriptions and send messages to your doctors. I've found it an invaluable tool for staying on top of my husband's medications. You can check it out on my links list.
Throughout this long journey with VA, my husband has had various minor surgeries to make his life a bit better. The VA does everything it can to make a veteran's existence as comfortable as possible. Their outlook is that these people served our country and now it is their turn to serve the veterans.
With each health issue we've had to face, VA has been very helpful in determining which can be considered for increased benefits and/or service-related issues. Once a claim has been presented, we've had our answer within a couple of months, most times within a month or less. We've been very pleased with that aspect of VA care.
As you walk into our regional hospital, there is a message above the doors leading in to the facility from the main garage, as well as in the lobby: "The price of freedom is visible here". When I first saw that, it brought tears to my eyes, because all you have to do is look around to see what many of the veterans have paid for that freedom, yet they are very humble and appreciative for the care they are given.
I thank God every day for the care that VA has and is giving to my husband to make his life easier.
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