what should I expect?

[Coleen]

I'm going for my VA 'intake' appointment for my medical in 2 weeks - any idea what I should expect? I've had the same PCP for 16 years, so this is a major change for me & I'm more than a bit nervous. Thanks

[Veteran Advisor]

I'm going for my VA 'intake' appointment for my medical in 2 weeks - any idea what I should expect? I've had the same PCP for 16 years, so this is a major change for me & I'm more than a bit nervous. Thanks

Rev Coleen,

You should expect a professional team of health care workers to do a comprehensive assessment of your medical history and present state of health. I'd advise you to ask about and take advantage of any programs, like smoking cessation or support groups, that may address any wellness issues you face. Like anything else in life, your experience will depend on a lot of things, but an optimistic attitude is a good place to start. Welcome to the VA system.

[Semper Fi]

Rev Coleen,

I go to Jefferson Brks in St. Louis. They are very professional and very helpful.
Jefferson Brks has its own SCI building so it is really a tight group.
You will be run thru the mill. exam, blood test, urine, ( do not eat prior), phyic, Social, physical therapy, Occupational, ect. Our Doctors are very good only do SCI. The support staff works just with SCI and are great. Hope you have the same type of facility. Let us know how it went.
Semper fi

[Coleen]

Thanks, guys.

[Coleen]

Oh, the VA doesn't know I'm probable chronic CES or am SCI, but they'll find out at my intake. I've seen the Patient Services Assistant, and she knows I'm in a chair, but didn't ask why. Will that make any difference?

[SCI-Nurse]

This first appointment will be important as you should be assigned to a primary care physician and clinic at that time. If you are going to Seattle, you need to ask to be referred to the SCI Center clinic for primary care. They can take it from there. Did you get rated as a category 4 when you did your eligibility? If not, they can help with that. Of course you also need to get ahold of and work with the PVA National Service Officer there.

(KLD)

[Coleen]

I'm cat 5, but they might change that. I'm going to American Lake for my intake, but I'd do Seattle, if they recommend it. American Lake had the first opening and are closer.

[Coleen]

Well, tomorrow's the day I have my intake at American Lake, and I'm getting pretty nervous. Hope it goes ok - it's the first time I've changed PCP's in 16 years, so I guess it's about time, especially with the poor help I've been given since April with my medical issues.

[quadvet]

All the best, Colleen, let us know how it goes.

[Timo]

Good luck to you and I hope you will get the care that you need.

[Coleen]

Saw the intake people yesterday - well, some of them, anyway - my appointment was late in the afternoon. I have to go back today & get scheduling done for some stuff - including to see a neurosurgeon - the intake guy was NOT impressed with the answer the civilian doc gave - ("it's not bad enough to fix yet") and wants me to see their surgeon ASAP. They also put some special dressing on my non-healing foot wound, and are sending me to the wound clinic, heart doc & he's recommending that my 'assigned' doctor will see me asap & emailed her that he believes I need to be bumped to a cat 4, so who knows? When I find out, I'll update!

[BigK]

Hi Coleen. I just wanted to make sure you are careful about this. I have gone to the VA and they can be really helpful and have done good work for me. But, I have also heard some horror stories too. It seemed to me they can be very surgery happy sometimes and a lot of residents from the local hospitals do their internships there as well and the head docs like them to get their training there as well. I don't know your situation and i'm sure they are trying to be helpful but no matter what, it is always good to get at least one or two other opinions with anything like this. I hope it works out for you.

[quadvet]

Sounds like it went good, Coleen, congrats. I hope the other appointments went well. You would do good to be bumped to category 4. BigK makes a good point, though I've never figured out how to get a second opinion with the VA. Do your homework, looking forward to good news.

[Coleen]

Bigk & quadvet, This will be the second opinion, but I'll be very careful!
So far, things are ok, we'll have to see how things go from hiere, I'll keep in touch about it.

[skippy13]

You will probably be very busy with initial appointments for a while. I still go to the VA for one thing or another at least four times a month at their request. Two times this week so far.:)

They do take good care of you, but I would recommend getting a calendar book for managing your appts. Write down any questions in it, keep track of all your appts, write a brief reminder to follow up on all suggestions and anything else you can think of. They are very busy and sometimes things fall through the cracks.

Advocate for yourself, educate yourself and take care of yourself. My appointments usually last about an hour or so each and are very thorough. Take advantage of anything and everything that you are entitled to.

Good for you girl, you got in!

[SCI-Nurse]

Also, be sure you register for My Healthe Vet. Anyone can get to the general information there, but if you register, you can use that website to check on your appointments and re-order meds and supplies. Eventually you will be able to actually read your chart, check on your lab results, and e-mail your provider using this secure site as well. You must register on-site at a VAMC as you must show proof of identity at that time (govt. issued ID).

(KLD)

[Coleen]

Thanks everyone! I got a call from the spine clinic (I forget the real name) at VA in Seattle & have an appointment there on the 5th of November. I also meet mt new PCP on the 29th - Dr Sharon Gill. I'm told she's really good & a nice person. They're putting me on a 48hr heart monitor on Monday because of my PSVT & Princemetals angina. There's a bunch of appointments being made, so the calandar is a good idea. I'll register for the online access next time I'm there.

[skippy13]

I love the My healthy vet website. I can re-order all of my meds online. They usually take about a week and a half to get to me, so watch your meds to make sure you get the order in on time so you never run out. Sunday morning I refill my med tray and then place any orders necessary. The refills come right away to my mail box. Easy.

Sounds like things are moving right along for you. Good.

[NWMom]

Coleen, I hope that they take good care of you there. Wishing you well!

[quadvet]

Ahh, I see now that you went to the hub clinic at American Lake for your intake, and go to the Seattle SCI Center in November. They can be really good and they care. Just don't fall through the cracks...and don't take "don't call us, we'll call you"; be diligent or vigilant in following up, whatever it takes.

Do register for https://www.myhealth.va.gov/ next time you're at the VA, it only takes a few minutes, and it's pretty handy.

All the best.

[Coleen]

:tape: Went in for labs & a pneumonia shot - my second day & vist there - nurse game me the shot, the when logging it into my record, looked at the vial, excused herself & all but ran out of the room. 20 minutes later, she poped her head back in & said she'd be right back. 10 more minutes & in she comes with the PA - turns out she gave me a full vial of the under the skin TB testing solution. Lovely. Vitals & an EKG & another hour later & they decided to give me the pneumonia shot in 2 weeks, and they'd called the company & was told I should be ok. I'm going to ask to be tested for TB in a month, just in case - in 2 weeks, it'd still show 'positive', I believe. Guess I've had my 'glitch'.

[SCI-Nurse]

That is a totally unacceptable error for them to make. Please contact the office of Risk Management and ask that they implement a RCA (root cause analysis) immediately to get to the cause of this error, and implement measures to prevent this from ever happening again. You should also get a formal disclosure and apology from the VA about this error (there is a policy related to this). Contact the Patient Advocate to be sure this gets done.

(KLD)

[quadvet]

"should be ok"..gotta love the VA sometimes.


Glad you're still with us Coleen, honestly, it could have just as easily been a deadly drug they gave you. As KLD alludes to; good advice there, too, thank you.

KLD; should she also contact her PVA National Service Officer about this?
.

[Coleen]

KLD, where do I find a patient advocate? would the paitent services assistant be able to help me with this? It's an easy one - the pharmacist gave the nurse the wrong vial, the nurse didn't check the vial until after the injection.
I'll contact whomever I should, as I'd rather this not happen to someone else also. Thanks.

[Veteran Advisor]

KLD, where do I find a patient advocate? would the paitent services assistant be able to help me with this? It's an easy one - the pharmacist gave the nurse the wrong vial, the nurse didn't check the vial until after the injection.
I'll contact whomever I should, as I'd rather this not happen to someone else also. Thanks.

Hi Coleen,

Sorry to hear about the mix up. I'm sure all will be fine, but keep careful notes in case something arises later. Names, dates, who said what, etc.. And keep copies of your treatment records whenever possible, particularly when you sense an error might've occurred.

As far as patient advocates, you can seek the assistance of a VA patient advocate at the facility or you can sign on with Paralyzed Veterans of America and have the Senior Benefits Advocate in Seattle assist you. Here's the contact info:

1660 S. Columbian Way, Rm 1-B-163
Seattle, WA 98108
206-768-5415

[Coleen]

Thanks! I'll be in the Seattle VA on Nov 5the to be seen at the spine clinic, so I'll check that out.

[SCI-Nurse]

KLD, where do I find a patient advocate? would the paitent services assistant be able to help me with this? It's an easy one - the pharmacist gave the nurse the wrong vial, the nurse didn't check the vial until after the injection.
I'll contact whomever I should, as I'd rather this not happen to someone else also. Thanks.



The pharmacist made a serious error and so did the nurse. Every nurse knows that it is their reponsibility to check the "Five Rights" before giving any medication. This includes:

Right drug
Right patient
Right route
Right dose
Right time
Clearly she failed on both the first and fourth of these.

Every VA employee at the CBOC or medical center should be able to direct you to the office of the patient advocate. You can call the hospital operator and ask to be transferred to their office. The same goes for the office of Risk Management.

You may go through your PVA NSO as well if you wish, but my understanding is that you still have not linked up with this person. Do not delay. Don't let another day go by without reporting this and demanding a response, which is your right and the VA's responsibility. November 5 is WAY TOO LATE!!!

(KLD)

[Coleen]

I talked to the patient advocate & risk management yesterday afternoon, and all is being taken care of. I've also requested that TB testing be done 4 weeks from the event. I don't know if there's any 'danger' of them having given me TB, and I'm probably being over cautious, but isn't the TB testing stuff active? Please correct me if I'm wrong about that one!

[Coleen]

Started with the VA's coumadi clinic yesterday - I first balked at a 1 1/2 hour 'class' as I've been on coumadin for multiple years, but was I wrong! I took home some really good info! Also have to see the vascular studies people for a 'non healing foot wound' but I don't see how that applies. Oh well, I guess they almost know what they're doing! Had a re-do test for cryoglobulinenemia yesterday, too, & see the oncology department on 11/17 for that. Things are moving pretty quickly, and I feel like I'm in a whirlwind! My civilian PCP says to do PT, the VA says not to - it's a little confusing. I've decided to drop my civilian PCP, though - too many cooks!

[skippy13]

Sounds like you are filling up your appointment book for sure. They can move rather quickly when there is reason to.

I hope you are getting good care, but you do have to be an active and educated participant in what they are doing. I'm sure that you are doing just that. I also did the same and dropped my civvie PCP. The VA is really very good despite the medicine mistake. That will never happen again with you I bet. You won't let it.

[Coleen]

I ask lots of questions, and will now question any injection before I get it! I see the spine people at the Seattle VA on the 5th, and have an appointment every day next week. Ugh! Oh well, things are happening pretty fast, for sure, but they'll slow down pretty soon, I'm sure.

[Coleen]

I'm confused - the PA at the VA said not to stand/walk except to transfer, my 'old' ARNP PCP wants me to do PT - the PA said that if the disks are 'touching' my cord when I'm laying down, it's going to much worse when I'm vertical, and today, my right (so called 'good' leg) is hurting something awful to bend - I'm not sure if that's the weather or just doing PT. any suggestions? I'm thinking following the VA's recomendation is probably a good idea, my old PCP hasn't done much to help.

[quadvet]

Glad it's working out for you, Coleen. I'd agree to follow VA advice regarding PT, they must have sound reason for it. Hopefully they'll shed light on that, and your leg pain, this week at your appointments.

I'm assuming - because no one said otherwise - that you are correct that the TB "testing stuff" is active; but that you are safe, for the same reason - no one said otherwise.

I still have a civilian doctor, mostly because I live quite a ways from the VA.

I hope your leg gets to feeling better. All the best with your appointments this week. :thumb:

[SCI-Nurse]

Coleen, are you going to the "spine" clinic (ie, ortho or neurosurgical spine) or to the SCI (spinal cord injury) clinic at the Seattle VA? Big difference. Regardless, I would not do anything right now as far as exercise until you get more expert evaluation and advice at the VA.

(KLD)

[Coleen]

The earliest appointment for the SCI clinic was in January, so they're sending me to the "spine" clinic on the 5th for eval & whatever.

[Coleen]

Thanks, KLD - I'm not actually able to walk right now, I can still transfer, but walking more than a few steps causes herrible spasms. I see my new PCP today - Dr Gill - so I'll see what happens. I'll keep you posted.:high5:

[Coleen]

What a difference! I'm cool with my new doctor - she's complete & thorough, friendly & just plain cool. She's going to be checking into my category, too.

[Coleen]

I see the spine clinic in Seattle on Thursday - I'm nervous about what they'll say - if they say surgery, I'll go ahead with it, if they say not right now, then that's what it'll be, and I'll have to get used to living like I am - and going downhill the whole time. Ugh!

[dan_nc]

Good luck, Coleen.

[Coleen]

Thanks, Daniel.

[skippy13]

Good luck tomorrow, Coleen!

[Coleen]

Thanks, Skippy13. I'm nervous, but will try to keep my focus.

[quadvet]

All the best, Coleen, think positive.

[Coleen]

The VA wants to try to rehab me & is putting off surgery until my "legs are stonger". It didn't make much sense to me, but I guess that's how it's done here. Hope there's no additional 'problems' from the rehab.

[skippy13]

I don't know of too many surgeons who will jump right into surgery without exhausting all other options first. Every time you see a new doc, they want to try all other treatments first.

You know that surgery is probably an eventuality, and that you will probably end up there, but that is just the way most surgeons do things. Frustrating I know, but that is the way it is for most things of this nature.

[Coleen]

I don't mind waiting - surgery is a big thing. I just don't want anything to be further messed up doing rehab. Waiting is cool, more problems isn't.

[Coleen]

Turns out I saw a rehab doc & not a neuro surgeon. I'll talk to PCP about it when I next see her. In the meantime, the rehab doc will be starting me after the cardio guys say it's ok, so that'll be sometime in December. If it's not one thing, it's another, although rehab will either help me or 'finish me off'.

[quadvet]

I'm not an authority on this, but the doctor you saw and neurosurgeons should have consulted each other on your behalf to judge what needs done. Then that doctor would have passed that judgment on to you at your appointment. I think that's how it works, maybe KLD or someone familiar with it will chime in.

Of the several surgeries I've had there, I don't recall seeing surgeons till the surgery has been agreed upon between the SCI doctors and them (the surgeons).