The backstory: female combat veteran, OIF, tries to get help for nightmares and increasingly horrible panic attacks, startle reflex, panic and fight or flight response. Agoraphobia develops after woowoo methods of treating panic attacks don't work. Nightmares lead to stress, migraines, gritting teeth and jaw so hard that teeth begin breaking. And so on.
In return for these attempts to get help, I get put into a therapy group full of sex offenders, then into one for housewives----with the admonition to 'be tactful'. About combat? About war? Three serious suicide attempts, one half assed one----and that one came after I checked myself into the psych ward, as I'd learned to recognize that not wanting to live is not quite the same as wanting to die. While I was in there, a male patient threatened me, because the men and women aren't separated. The nurses said, "Oh, honey, what can we do? He's nuts." Then I talked to my shrink about how the suicidal feelings weren't going away and---knowing that I was terrified of being back in that place-------she threatened me with involuntary commitment to that very place if I ever spoke of such feelings again. Requested new doctor. That was years ago. Have panic attacks around vehicles, possibly due to the fact that, in my CO's words, "We did hundreds of patrols while we were there, and she was our gunner for a lot of them."
Following the request for a new doctor, the VA took away the transportation they'd been providing, which meant professional drivers who were used to veterans. Without transportation, a cab ride costs about $25.00 plus tip each way. (And because a lot of the cabbies are vets I always tip----and I tip well, because tip jobs just suck.) Because I once took a cab to the ER, my shrink started hinting that I was just malingering about the panic attacks, which keep me in my house, because outside I get seized by sheer utter terror if I let my guard down for one minute. On a couple of occasions in Iraq, I and other soldiers got exposed and pinned down by a sniper. I can still feel that sight on my neck.
Denying me transportation gave the VA the excuse to cut off all my meds at once. I think this was an attempt to make me do what is nearly impossible for me to do: get in a strange vehicle, especially at night, with a strange person, and go to the VA. I couldn't do it. I had a seizure when my meds ran out; I also stopped being able to sleep and started having hallucinations, probably due to exhaustion. I also started having what turned out to be migraine headaches, which I've never had.
I could go on and ON, but that's the background.
The patient advocate called me today. This is, for anybody keeping track, the fourth patient advocate I've dealt with in less than two months, one of whom argued I didn't need transportation because, hey, there was nothing wrong with my arms or legs, was there?, one who blatantly lied his ass off, one who never returned any phone calls---six of them----and this one, finally, who like all the others, subtly argued on behalf of the hospital. Not on mine.
So for years I have been asking for a change in meds and doctors. And as some of you guys might have noticed, I'm not subtle. Subtle will be the last word anyone ever thinks to apply to me, and even then it might involve bribery, sexual favors, drugs, and first born children. I also told my doctor that I had resorted to taking as much as: two klonapin, one trazadone, and a whole mirtazapine to combat the before-night jitters when I had an appointment at the VA the following morning. And those things did not work, and I still did not get any sleep, so I could not go to the only place I manage to go: the VA. (I only manage to leave the house about once every six times. I stop eating the night before. There's also throwing up.) I also told my shrink, repeatedly, that I had tried taking twice the dosage of Klonapin to try and fight the anxiety, and that it occurred to me that this----all of it----was not a good idea. I told my therapist this stuff and she gave me that polite suburban smile and changed the subject. I changed it back. She evaded and accused me of raising my voice. I told her there was a difference between enunciating and raising one's voice. She evaded. And so on.
I asked, repeatedly, for a change in meds. I've been saying this for at least a year. And a new doctor. Including at our last appointment. It's been a theme. I don't like being threatened with involuntary commitment. I don't like being ignored and patronized.
I asked for a new med because it's not working and because I've been on it for four years. I told her---I know I'm repeating this but I'm used to being ignored----that I had been taking twice the dosage but it wasn't working. She shrugged that off. Isn't that sort of thing kind of important? (The VA is kind of like the boyfriend who tells you you're fat so subtly and so nearly invisibly that you not only look like a tremendous ragemonkey if you tell him he must not want to have sex ever again, but also takes away the confidence to even make that kind of retort in the first place.)
She said she was worried about dependency. I told her, specifically, that I wanted a drug I could take as needed, because my 'anxiety' level----what a stupid word!---is just about unbearable. I sleep maybe two hours a night, if that. Every time I relax that sniper's sight lines up on my head and I jerk awake, gasping for breath, or flailing and screaming. I can't figure out if the nightmares are causing the daytime anxiety, or if the daytime anxiety---what a stupid word----is causing the nightmares. Until the anxiety is at a less crippling level, I cannot go to various kinds of therapy needed for my physical injuries.
I did not want to have to take more drugs. I was very specific. I just wanted something that would stop that train from smashing into me, multiple times a day, until the constant stress-and-collapse routine of adrenalin flare and ebb wore me out. It's great that I'm not dependent on this drug. However, it does not work, so I don't take it. Her reasoning appears to be that this is the best case scenario: no drugs, no dependency. "The best treatment is therapy," she says primly, but how do I get to therapy in the first place? That's the point at which she always changes the subject, I change it back, and then she accuses me of having some kind of inappropriate reaction to being patronized by some yuppie burb dweller.
Exhaustion does terrible things to you. Before the VA really started fucking with my meds and me----they really have no idea what to do with a female combat veteran----my house was immaculate. Now it's a mess. I drag myself out of bed, then stagger through the day, so tired even my brain lacks strength. I have problems with balance because I'm so tired. And then there are the migraines.
I collapsed in a hallway at the VA recently when I got a blinding----literally----headache and I couldn't get to a chair in time. Getting to a chair is the best and only option. Sometimes my head hurts so bad my vision blacks out. Then for an hour or more, I can't see, because there are flashing lights in front of my eyes. Pain is weakness leaving the body. I'd been grimly pulling myself from one wall to the next in my house, sometimes doubling over with the pain, because I was a soldier at one point. I once broke my leg in three places and hobbled around on it for an hour, thinking, "Gee, that feels kind of weird." (No surprise, all the fractures were immobilized by my jump boots.) It galled me to have to admit that here was a pain I couldn't stomp through.
I spent that day at the VA in a wheelchair. My doctor told me to 'keep a headache diary.' Somewhere around there, I noticed that I was gritting my teeth so hard and so often that they had started cracking and breaking. The VA misdiagnosed the resulting abscess at least once because they didn't bother to take my temperature---I had a fever----or take my blood pressure.
The patient advocate read from the doctor's notes from that last appointment with the shrink. "Patient has agreed to follow the treatment plan, which involves medication X (the anti-depressant that actually works) twice a day, with Medication Z (the contested anti-anxiety drug that doesn't) before bedtime."
No request for a new therapist.
No request for a change in medication.
No discussion of dependency, i.e.; how to cure headaches by eliminating the head, not the ache.
No details of what kind of medication I wanted----i.e., something that works.
No mention of what I specifically asked for, which was something that would bring the 'anxiety' under control. The patient advocate must have taken that class that I think they give to all VA workers, where they teach you how to be subtly undermining, because he said, "Well, those drugs that you can take when you start feeling anxious....."
Ooooh. Big mistake.
"Anxious,", I said, "describes what you feel before a date. Getting hit by a train is what I feel."
Stupid motherfucker, too, because he tried the same thing again a little while later in the conversation.
The bottom line is, the doctor wrote down exactly the opposite of what I said. She omitted everything I said. That's lying, plain and simple, isn't it? She can't do that, can she? She's ignoring everything I say.
I mean, the guy read me her notes.
This call, I suspect, came only because I called the Director yet again. I've called Senators, my House rep, the Governor, you name it.
The womens' center director has been forwarding my comments to the doctors and she was utterly baffled. "Well, they're signing off on it, they're receiving my emails, they're reading them, but then.....they don't do anything. They don't reply, they don't make recommendations, they don't do anything."
Even the insurgents shoot back.
I phone and I phone and.....they don't do anything. They refuse to listen to me. I've talked to other women veterans in the waiting room, and they say the same thing. The waiting room, by the way, looks like nobody's touched it since the Viet Nam war ended---and the only women represented in it are Barbie, babies, and nurses. There's boxes of children's toys, and flyers about "Military Sexual Trauma."
When I complained to my first therapist about the sex offenders in the first therapy group, she shrugged and said, "There's jerks everywhere."
Jerks. You know, a jerk is a guy who cuts you off on the way to work so you miss your exit. A guy who uses his position as battalion commander to coerce women into sexual acts is not just a jerk. Do you want the person who cannot see this guy as the institutional problem that he is treating a person who had to deal with other men like this?
Jerks.
I'm not writing this for pity or sympathy or whatever. I know there are more women like me out there, and the same thing is happening to them.
I didn't sleep last night. Again. My eyes burn and everything aches with tiredness. When I try and sleep the thoughts and mental images start to play, till my heart's beating a mile a minute. Before I know it, I'm wide awake again. These are some of the same symptoms the male veterans suffer from. In therapy, I watched guys who'd never left the States talk about the prescriptions they got just by asking, while women were subjected to off brand labels----and uses.
My doctor sent me a new medication a couple of months back. I asked for something I could take situationally, only when needed. She sent me something that had to be taken three times a day. And she didn't even prescribe the therapeutic dose. It's for people with neurological injury or illness.
Apparently, wanting to take as little medication as I can makes me....a medication seeker.
That wasn't in her notes, either.