Category: Paul

Curious how all our previous messages disappeared from the system before I logged in to send this today. Doesn’t appear real secure. They were already either relieving themselves of me, or perpetuating the cover-up.

Latest Symptom Log entry:

25 AUG 21: A month on from hyperemesis and I’m pretty miserable, irritable and hurting 24×7. Sleep loss has become an issue once again. Can’t really say Cannabis is addictive or harmful in any way whatsoever, as far I am concerned. I can sense the headspace with tolerance enabling me to over-use, as well as how it seems to affect my nervous system long-term, generally speaking. I’ll be starting up again, soon as it feels completely cleared. The fat-soluble nature of the active ingredients must allow it to build up to the point of excess. Probably many other unknown factors in the CB receptor realm, as well. I’ll keep better cognizance on how much I’m using instead of just continuously saturating myself with it.

Symptoms Log entry from a few days ago:

3 AUG 21: A week on recovering from Cannabis hyperemesis, “symptoms” takes on a whole new meaning. It’s a pretty stark before/after contrast with/without medication. Weed definitely tamps down the radiculopathy symptoms. Ability to better maintain balance on my feet seems to be positively affected, but that could be hyperemesis aftermath. The psychological aspect might be even more important – not being constantly distracted and depressed with paralysis and pain. Inflammation symptoms with the bad joints was totally gone until yesterday, from as far back as I can remember. That stuff was a minor annoyance compared to what I’m dealing with since the malpractice.

Looks like this is basically what I’ll have to work with:

13 JUL 21: Impression of lumbar symptoms after a month off decompression seems to suggest fusion with removal of the disc leaves things at that level fairly well solidified and inflammation / stenosis resistant – lumbar no longer responds to decompression. Nerve damage-induced paralysis in all the surrounding / connected right side musculature remains a severely debilitating, painful daily nightmare. Soft tissues around top of the knee (not in the joint itself, like arthritis) up through the quad, ilial on the right and both glutes and erectors are sore to the bone continuously. Nerve symptoms simmer down through the calf crunching my toes similar to how I’m always gripping with my right hand. This condition now prevalent throughout the entire right side of my body, starts first step out of bed in the morning and only gets worse through the day with physical activity – footwork – the term I now use for anything on my feet – walking or even just standing is always a forced march. Left side quad rebound jab stopped sometime recently.

C-Spine has once again become the dominant, disabling injury being “worked on.” At least the lumbar shouldn’t get worse, going forward.

With Memorial Day fast approaching and the 3rd anniversary of that ECHCS email update, and in anticipation of our informal review now awaiting scheduling under the 1151 claim, the script I expect to formally convey at that time is given below for your reading pleasure:

Dear VA,

Please allow me to apologize in advance for speaking frankly about this matter, because it affects me profoundly, and that is the only way I can talk about it. And thank you for the opportunity to clear up some sort of fundamental oversight or misunderstanding about this claim.

I never recovered from my left hip replacement in January, 2019. I’ve lost count of how many VA people I’ve told that since 2019. Nor have I previously complained about, or received diagnosis or treatment for any sort of lumbar condition from anyone, VA or otherwise, before then. A year later on February 22nd 2020, L4-5 was fused by Dr. Edward Donner, to remove a leaking disc marginally attached to the annulus from which it was torn. I have no idea where the notion of degenerative disc disease in my lumbar came from. Last year a C&P examiner noted among other things, a lack of ankylosis at C6-7, typically associated with that condition the VA now asserts in this malpractice claim denial. I have not been tested for the HLA-B27 gene, so this administrative conclusion appears to be another presumptive non-diagnosis, with no medical basis. The deteriorating conditions on either end of my spine certainly are issues, but osteoarthritis wasn’t the cause, and it’s not the leading factor now.

With the exception of my still naturally-functional knees rated at Air Force retirement age 45, now suffering nerve pain, all my currently problematic orthopedic issues including the hips, stem either directly or indirectly from injuries. My first claim for the loss of my right hip was precipitated by a motorcycle accident in 1986. The early onset of osteoarthritis claiming my hips as their first victims was an indirect result of that event. The C-spine was another vehicle-related accident, differing largely in it’s immediate manifestation. The knees and mid/lower spine were my only major body parts still functioning as intended, not yet sufficiently damaged from injurious traumas to require surgery before 2019.

A lumbar disc was torn open on January 8th 2019 by Dr. Andrew Park, in a fashion at least an order of magnitude greater than what happened at C6-7 in 2001. Fusion surgery to repair the leaking disc followed an eleven month-long fight for diagnosis with providers at the ECHCS VA facility in Aurora. For some reason they just flatly refused to diagnose me (re: Dr. Knight). What if anything was ever done about that problem remains in question. The abusive, negligent mistreatment I was subjected to in that denial-after-the-fact process is unforgivable.

I’m sure Dr. Park did his best, and the new hip is great, but pointing to that tear already being there calls for an explanation as to why I never complained about it before, why it was never called out in an MRI until the one I demanded in June 2019, and how every person who’s ever done a day’s real work in their lives has any number of benign annular tears up and down their spine. How a guy with a torn/leaking lumbar ever became a hip replacement candidate in the first place might be a good starting point, if the history of that L4-5 tear is in question. Much more pressure that day, and I probably would have been totally paralyzed.

Alarming new lumbar symptoms emerged the day I stopped pain med two weeks after the hip surgery. Dr. Park might remember exactly what I told him about that the day I finally managed to corner him, demanding new imaging after waiting for three hours. Dr. Sluder, my PCP at the time, told me “sometimes it just takes longer to get over an operation like this.” That is not the worst of the bullshittery I have been subjected to in this process, but I have only so much time here today. My pleas for help were systematically ignored while I was sent on the run-around.

I am a sentient being with intimate knowledge of my body, betrayed by the system I trusted to care for me. I know what happened, who did it, where it happened, exactly when it happened, and how it has left me crippled, and my life turned upside down in this ongoing travesty. After holding a Top Secret security clearance for 25 years I never imagined my candor coming into question in any official government capacity. Seems like that old accountability issue cropping up everywhere these days. The fact I was repeatedly steered away from and in fact, directly denied diagnosis (re: Iliev, Sylvestri, Brinkis, Knight, et al) was pure negligence.

Medical records need corrected and updated to reflect the true cause of my current condition. That goes for the topic of this claim as well. I don’t know where the degenerative disc nonsense came from, probably the same sort who tried to adjust my c-spine appeal in the government’s favor. This claim is for the malpractice suffered on January 8th 2019 in Aurora Colorado, resulting in a leaking disc requiring lumbar fusion to repair – period. The records need backed by a written mea culpa from the Director of that facility for the way I was treated during an 11-month long failure to diagnose. I also want a face-to-face meeting with Dr’s Park, Brinkis, their boss and whoever that Director happens to be whenever we get around to it. I have a few questions about some post-op protocols that may or may not be in effect there.

To Mr. Arnold Tovar, the person who managed to get me on the phone one day after my complaints reached The Secretary the 1st time: His response to this issue ending our conversation was “I know what you want…” followed by a long rhetorical pause. THAT should have been a foregone conclusion the moment Dr. Park pushed a little too hard. I came home from the hospital with a black-and-blue left foot. Seemed odd at first, making more sense later after the medication wore off and festering set it. They broke my back and left me to rot. The look on that resident’s face who came to check on me the morning after a 180+BP breakthrough episode said it all. Too bad I was too drugged up to know any better at the time.

Then they refused to diagnose me. Imagine that. Things were obviously done so I would not be diagnosed. A comprehensive look at the record clearly shows that to any cold-eye reader. This type of mistreatment will not be considered acceptably de-riguer, and those responsible will be held accountable. Brinkis’ vague referral after I told him what was wrong with me made a great red herring for the first couple spine guys. Knight spent more time looking for needle tracks than she did trying to figure out what was wrong with me. I flushed out another one in Loveland upon arrival, but got lucky with Donner, because I was at the end of my rope. Imagine living a year with a festering back injury on top of a fresh hip replacement with NOBODY willing to admit there was anything wrong with you. Withholding diagnosis like that was torture.

My repeated response to anyone questioning any aspect of this claim or the veracity of any statement I have ever made about it in any format: What 60 year-old doesn’t have normal low back pain? My mid-lower back was probably the only remaining portion of my skeleton not seriously damaged or degraded by injuries before 2019. The Social Security Administration now asserts that a former tech worker such as myself is not disabled because they can still sit in front of a computer. I imagine if the government had their way, I’d still be in front of their computer in a wheelchair. Being partially paralyzed throughout the entire right side of my body now has me starting to envy some of the new prosthetic limb tech – at least they can move about more-or-less at will.

VA bureaucrats need to spend a few minutes reading the true account of what happened to me, if you haven’t already. It’s a lot easier to understand and much shorter than the medical records, which are well cited. I hope this provides a good example to help future victims. I could see what they were trying to do after Brinkis’ referral, so I wrote it all down. I’m still waiting for somebody to explain how the right side of my body went out following a left hip replacement. Let me know when you figure it out.

Sincerely,

Paul D. Shaffer, MSgt, USAF (ret.)

P.S. CSI gets a pass, only because they were misled – but the insurance shakedown and phytocannaharvaresia were things. Props to the Colonel and his crew. The right hip seems to have held up well under two years of his successor’s abuse. It’s well shielded with the hard limp I have on it now.

(Submitted to the Board of Veterans Appeals 15 JUN 21)

I updated this last Symptoms Log entry to include the latest impression of what’s going on with me today:

30 MAR 21: No change. I’m going to start using the brace and/or cane continuously, whether I think I need it or not. Maybe that will at least delay the daily onset of more acute symptoms by evening. The lumbar has settled into somewhat of a steady state over the past couple of months. It’s the same thing that happened to my C-Spine in 2001, only much worse.

Around the eight years ago time-frame, my upper right quadrant including the upper back and right shoulder got into a real bad trajectory. I’m pretty sure things finally went south there for good after trying to catch the rear axle coming out of that ’74 Duster. Can’t really pin any one event on the shoulder issues, but it had been bad for years, rated for disability at retirement from the Air Force.

So after the shoulder finally became more-or-less non-functional and hurting pretty bad, we went through a two-year VA diagnostic process detailing what I summarized in the 1st paragraph above. The C-Spine has been a worsening chronic factor since 2001, so I had some PT for that, and after some more time, x-rays and indecision, Dr. Sylvestri finally ended up rebuilding the right shoulder, somewhere short of a total arthroplasty. IIRC, the final tally was the sub-pectoral, 3 cuff tears and some bone spurs. It’s still pretty painful, but at least I can use it now, so that eventually became an overall great outcome.

During that process I’m thinking this disability thing’s getting more real all the time and applied for a rating increase on the C-Spine, which was summarily dismissed. This must be a big issue for the people with hard-to-see stuff like me. I’m pretty sure unless you show up missing a leg from an IED attack or something similar, they just deny every non-obvious claim by default. So after being around this block once already with the right hip replacement, I determined an appeal was in order. It took awhile, but they finally got it right. I wonder how many years worth of my increased compensation benefit it will take to match the amount spent trying to deny it:

Note that is just the last page of a fifteen page decision letter. The level of byzantine detail they go into is unnerving – no pun intended. I would like to know why they included recent year’s evidence in an six-year-old claim appeal decision, referring to a lumbar injury only a few weeks ago determined to be degenerative disc disease by a VA administrator(?). It’s insane. They were probably going to rate me totally disabled before I had my back broken on the operating table two years ago. Maybe that was just to make sure.

I’d post a snippet from the boilerplate malpractice claim denial I received a few weeks ago, but there’s no point. I wonder if they’d approve that claim for somebody picked up off a battlefield with a torn lumbar?

It’s a matter of adapting and learning to do things differently. Use leverage, split things up into smaller chunks, take lots of rest breaks. For example, it took almost 3 months to complete the deck refurb last spring/summer, on a job I’d conservatively have estimated taking 2 weeks max, if I could just work on it all day. The worst part is one of the things I really enjoyed and planned to spend my retirement doing more of – hiking with the dogs – is mostly out the window. It’s just no fun anymore. Any time on my feet is a forced march now. I’ve lost full use of the entire right side of my body. I am what we call “butthurt” – literally.

24 JAN 21: Took the dogs on a long (1hr) walk yesterday trying to establish Monday as “long walk day.” Muscle strain/soreness was acute last night and little diminished this morning, with the right thigh twitching at an alarming resting rate. Sometimes I can drive it and the right glute into continuously twitching to the point of making me stop whatever I’m doing if the particular activity is aggravating things in just the wrong sort of way. Basically any type of movements on my feet be it walking, light housework, playing with the pets – anything involving ambulatory movement aggravates it to some extent, with the glutes and right leg stiff and sore 24/7. The glow from L4-5 expands to eventually include the entire midsection and right thigh until muscle exhaustion sets in before long. It’s difficult to describe, not pain, but a building tension or intensity that eventually becomes overwhelming. Actual pain now comes from the left side rebound and the right knee, when it flares.

After two major surgeries a year apart early 19-20, the 2nd to correct damage done in the 1st, indications from both are I’m probably lucky to be alive.  Been around this block enough times to know what’s coming up at the corner.  I was worried about the right knee a few weeks ago, but it’s pretty clear what’s up with it now. It’s the same nerve thing that feels like a pair of vice-grips applied to my elbow when the C6-7 part flares.

The topic is a new term I coined myself for the sensation of undergoing major surgery (lumbar fusion in this case) with inadequate anesthetic.  This one definitely gets filed under the “Whatever doesn’t kill ya…”  category.  Even spine doctors need a little education once in awhile:

Subj:  Shaffer / Update
From:  Paul <acewiza@gmail.com>
Oct 23, 2020, 7:29 AM
to frontdesk, Michelle, Francie, Phoebe

On 2nd thought, I’m pretty sure I don’t need any more midsection X-Rays. Maybe my last message was misunderstood, but I really just need to hold off on any more medical care for the time being. I thought we were in a Q’n-A session and it was your turn to go. The tele-health thing only goes so far. I just want to thank everyone for getting me taken care of. The rest of this is to Dr. Donner, directly:

[/donner-on]

Remember getting a call from the recovery room nurse? Put that on the back burner, we’re gonna return to it.

I’ve met at least a dozen doctors in recent years, however you did more for me in 1 day than all the rest of them put together. The new left hip is nice, but it came with a big surcharge. So this was the 1st time I ever met a new doctor with a handshake attached to somebody I couldn’t see a half minute before getting stuck with a discogram machine. Seemed an odd way to meet a new doctor. Is that typical there?

…Maybe it’s related to the next question, so what’s up with Chris’ comment about a little Fentanyl before the procedure? Teasing for a reaction after Thieman referred me as probably just another attention-seeking drug user? The young lady who introduced me to Chris mentioned you see alot of his patients. Probably just me being weird, but that seemed odd too.

I still wonder if “the VA” (meaning individual healthcare personnel directly concerned with me) recognizes just exactly how wrong they got it – all the way through, on many levels, up to and including their (former?) Chief of Orthopedics at the big new Aurora hospital. Acceptance is hard to find without definitive elucidation.

But you’ve certainly mastered the scalpel part. Regardless of your pharmacology skills trying to talk me out of the only medication that ever helped with this nightmare, please discuss any Cannabis-using patients you may have with the anesthesiologist going forward. Those people need more anesthetic – alot more in some cases. Put it on one of your surveys if it’s not already. Then ask again, because despite it’s current legal status in CO, patients may be reticent to talk openly, due to lingering pockets of incorrect orientation on that topic.

Maybe it was all good and that’s just how it goes with these procedures, dunno. And like I wrote on the questionnaire, I am a 100% satisfied customer. But I’m afraid I might inadvertently laugh out loud next time I hear some woman mention the pain of childbirth. That’s coming from a guy thru 2 hip replacements, with the 2nd including a torn L4-5 annulus for good measure. Try rehabbing that. I imagine it could potentially be quite unfortunate for the phytocannabanoid – anesthesia interaction to go wrong in a bigger way on somebody else.

I can still walk at least a bit, seems like a big plus at this point – and I will be eternally grateful for the fusion repair. I just want to know what’s wrong and what to expect. That sentiment hasn’t changed since around the middle of last year either, maybe it won’t ever. That’s why I was planning on attending our last appointment, maybe a c-spine preview, but that would call for a new referral and there’s really no point. The masks hide facial expressions, and I recall hearing you mention you saw all you needed to see last time.

[/donner-off]

…and THANKS AGAIN to everybody! 🙂

–Paul D. Shaffer, MSgt, USAF (ret.)

LATE UPDATE: Just FYI – Marijuana is a topic on one of the pre-engagement surveys, and I stopped all Cannabis four full days prior. Minor adjustment, or complete oversight? We’ll probably never know.

I’ve come to expect dealing with the government on just about anything is always going to be a non-trivial exercise.  Twenty years in the military followed by 13 contracting for them leaves me circumspect about my troubles with the VA.  They fixed my hips, despite denying service connection, so still an overall big plus by any measure.  Round 2 took over 7 years for them to recognize just exactly how messed up my c-spine is.  They (VA) now await the paperwork on this:

19 OCT 20: Nothing really changed with the Gabapentin. Mostly I noticed stumbling around and dropping stuff all the time more than usual. Muscle relaxant before the surgery just made me constipated. The brace helps make uptime less uncomfortable, while my butt, quads, obliques and lo-back continue getting very stiff and sore. Feels like I been on my feet 10 hours every time I sit down. Pushing myself to walk 2 miles around a lake, whereas before the left hip went out I was doing 20 miles in the mountains for fun. Cannot stay on my feet for more than an hour or so without extreme discomfort. Been using the foam roller and bending/stretching every day for going on 2 years. Wondering if I should expect to make the brace a permanent part of my wardrobe? I already bought a new one last month since the Aspen velcro’s almost gone.

Overall improvement after the surgery was dramatic and steady for 4-5 months without constant pain from the injury. But it plateaued with this muscle strain/tension. I can now clearly tell I’m no longer walking right. Getting up stepping off, feels like the right side is a half second behind the left as I drag it along. Although maybe not really needing it, I seem to “want” to use the cane in the left hand and now always start with a little limp to the right. The related muscle symptom(s) has not changed appreciably since mid 2019. Top of the right glute and lower-right erector are pretty much continuously lit, like the right rhomboid at my C-spine. I feel exhausted at the end of every day, after not doing much. Pushing myself to do more leaves me wiped out. Sometimes the glute does this random twitching thing. Did it alot last year and up to the surgery. Stopped for a few months earlier in the year, started again, now including the right quad last month. Gabapentin?

I would really like a current medical assessment. What’s the story on this nerve root damage? Apart from PT, we have little-to-nothing for treating the symptoms, and it’s permanent right? Give me a call, email or message here if you or the Dr has any questions before our appointment. I have a couple more me and Dr. Donner are gonna talk about privately. We need to clear something up, and I want an authentic, targeted prognosis, not false hope or drugs.

It’s time to get past the Marijuana thing.  If your body is anything like mine, and I’m pretty typical, by the time you reach 60yo things start wearing out and breaking.  If you’re more like me, you were already breaking stuff a long time ago.  This is what I look like to the Veteran’s Administration at this time.  At least it seems they fast-tracked the C-Spine appeal.  That was starting to get ridiculous.  I’m awaiting the 1st formal response to my recently filed 1151 for the left hip/L4-5 malpractice.  That’s the worst of my medical issues and not even in the mix as far as they are concerned right now.

You’d never know it by just looking at me, but I’m pretty messed up – dual nerve root damages with advanced arthritis everywhere and lots of surgically-installed metal to show for it.  I had a couple scary episodes with prescribed pharmaceuticals, taken as directed in recent years.  I suspect the combination of Tramadol, Venlafaxine and Gabapentin nearly gave me serotonin syndrome.  Etodolac sent me the ER with chest pains.  I doubt my kidneys miss the mass quantities of NSAIDS.  Alot of it is downright toxic.  I’ve swallowed enough pills to kill a horse over the years, but I’m still alive.  I credit The Weed.

They don’t like to admit it, but the medical community doesn’t really have much to treat this type stuff long term, except joint replacements.  I’m living proof of that.  Nada for the neuropathy/radiculopothy.  But Cannabis does the trick.  It’s no cure-all, just an effective home remedy for these sorts of things making life tolerable.  The government and medical community needs to wake up and smell the Terpenes.  Get with the program.

After dealing with dozens of doctors over the years who like writing drug prescriptions and rarely ever seem to find anything wrong, this was a real breath of fresh air.  I assume partial responsibility for my failures with the medical community, because I just don’t know how to deal with them or trust anybody.

Jeff, the guy from the article, has the exact same cervical spine injury I do.  He literally exactly describes the symptoms I was suffering 7 years ago before getting my shoulder repaired.  Fortunately or unfortunately depending on your perspective, the C6-7 injury was only a contributing factor in the shoulder job, and continued worsening with Degenerative Disc Disease ever since.  Spinal decompression currently maintains it at a lessening tolerable level, but the writing is on the wall:  A spinal fusion surgery for that could eventually be a possibility.

Fast forward to January 8th 2019, where a VA-contracted surgeon skillfully tore open an annular tear at L4-5 during a left hip replacement.  That one’s fused now, but the end result is nerve root damage afflicting me at both ends of my spine.  Looks like we are in the wait-and-see stage with Dr. Donner.

So I copied the Robocop post link to  the Spine Doctor in their messaging system a couple weeks ago, and got a call back asking to try the Gabapentin again.  Too early to tell if it does anything, but maybe it will mask symptoms for awhile.

“2 SEP 2020: After experiencing ongoing neuropathic dysfunction due to the nerve root damage, Dr. Donner’s PA (Bob) gave me a new prescription for Gabapentin. With things back to baseline in terms of overall pain and inflammation levels, I can tell the lumbar symptom remaining is pretty similar to the C6-7 injury I got 18 years ago. It produces a constant low-level signal crunching the muscles closest to the injury site, radiating out from there to a lesser degree. At it’s worst before the lumbar surgery, the entire right side of my body was joined in this fashion with moderate paralysis engaging through the scapula to the right shoulder, all the way down my back, though my hips and down the right leg. Interestingly, I have a big, painful callous on the tip of my right big toe from it crunching up subconsciously. We’ll see if the Gabapentin calms it down. I was taking a max dose of that stuff for years back when the C6-7 issue was raging and did not seem to have much luck with it. We’ll try it again…

Had the 6-month followup with Dr. Donner yesterday.  Everything looks good.  Certainly feels alot better than it did this time last year.  Apparently nerve root damage will leave me a little more crippled going forward.  Hoping it will resolve better over time.  At least it doesn’t hurt like it did before.  I remember talking with one of the docs a few years ago diagnosing the shoulder.  I jokingly quipped it probably wouldn’t be long before all my major joints were replaced.  She laughed and replied “oh, that never happens!”  I’m well on the way.

“12.AUG 2020: 6-Month Followup with Dr. Donner, and everything looks good. Minor healing discomfort which I expect to continue diminishing and remaining nerve root damage are the only notes from the lumbar surgery. The right knee is bad. We’ll need to see how I can nurse it along. I do not expect to have any further dealings of significant import with the healthcare system ever again.”