Falling in to the VA Rabbit Hole

**After a 7 year career as an investigator, I am now a full time caregiver to my Ranger husband. In 2011 he was critically injured by a suicide bomber with a hand grenade. He was medically retired in 2014 with a 100 percent service connected rating. I blog so that the highly publicized shortcomings of the Army Medical Evaluation Board and the VA can be seen through one families personal experience and how decisions made by  those in charge trickle down to those most in need of care.**

As a caregiver, my role at the VA is to advocate for my husband, ask important questions about the recommended treatment plan and provide an emotional buffer to the stresses caused by the system. I do my best to remain calm, patient and respectful. This is no easy task.

My husband has very complex injuries and as a result he frequently falls. His falls are caused by leg injuries, nerve damage, TBI, and vision loss. After several serious falls, including knocking himself unconscious after a fall in the bathroom and, on a separate occasion, almost going over the second level railing at a football stadium, we knew he needed help. The journey to get the appropriate safety tools took 6 months.

He was first evaluated at the poly-trauma clinic who determined that, at a bare minimum, his falls could be reduced with leg braces. The clinic ordered X-rays and sent referrals to orthopedics and prosthetics. Prosthetics decided, without evaluation or knowledge of the internal structure of my husbands feet that orthotics will fix the falling. This idea seemed ridiculous to both my husband and I but we went along with it anyway.

Several weeks later, we were able to see the orthopedist. After his evaluation  he laughed that prosthetics had issued him orthotics to try and rectify his falling. The x-rays revealed three large shrapnel pieces that reside in the right foot. The x-ray also showed how his tibia and fibula are titanium rods screwed into his ankle joint. This severely limits his range of motion. The orthopedist prescribed "Ritchie Braces" which encase the ankle and heel to steady his legs and sent us back to prosthetics for casting.

This is when we hit a brick wall. The prosthetics department REFUSED to make the braces. They told us, "You saw the worst orthopedist in the VA system so we will not do what he recommends." Patients have no control over which specialty doctor they are assigned to and although no one in the prosthetics department is a medical doctor they believed they had the power to veto what was recommended.  On top of suggesting my husband was "perhaps putting the orthotics in backwards" they suggested we go back to the poly-trauma unit to determine "why he is falling."  Essentially, they wanted us to start back at square one.

We were turned away twice by the prosthetics department as they shared their clear disdain for the orthopedist who had suggested the braces. At this point, 4 months had passed, my husbands falls continued, and my patience was wearing thin. We decided to make a third attempt at getting the braces. This time, I refused to leave until he was casted. It took me 3 hours and taking a poster off their wall that listed "The Goals of Prosthetics". I pointed to number 9 on the list which stated "reduce the risk of falls". They begrudgingly gave in and casted my husband.  After another two months, and several calls attempting to dissuade us from the braces , my husband can finally walk with a sense of security.

No veteran or caregiver should have to experience such mismanagement of care nor should they have to fight tooth and nail for what a doctor has suggested.