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31 October 2015

The VA. Also, Halloween in Madison

I've been sick all week, my immune system having been beaten for a time by some random bug that's making me cough, keeping my throat sore, and generally making me feel like crap. After work Thursday night I went home fairly early, guzzled some NyQuil, and slept for most of Friday. Today/tonight I'm feeling a little better, although I'm still eating cough drops like they're candy. I thought more than once this week that I should consider calling the triage line at the VA Hospital, and trying to get in to see a doctor. Some sort of antibiotics would probably help kill whatever bug this is, and I know that the VA pharmacy has way better cough syrup than the generic brand stuff I bought at the campus convenience store. Maybe.

I didn't call the VA Hospital. I really don't want to deal with the VA-- this is partly because I just don't like being sick, and I don't especially like hospitals and doctors and sitting in an emergency room full of other sick people. It's also, as I'm slowly realizing, that I'm deep down still pretty pissed off at the VA and it's making me pretty pissed off in general. I don't want to be the pissed off old guy in the room, complaining all the time about the VA. There are more than enough pissed off old guys complaining about the VA already, some with merit and some not, and in a broader sense I don't want to be the pissed off guy for any reason. Being angry takes a lot of energy I'd rather use for more productive things. So I didn't call, but I'm probably sicker (and for longer) as a result.

On the other hand, I need to let some of this stuff out.

I also need to call the VA Hospital and make a couple of other appointments, one of which is my yearly primary care appointment. The VA doesn't make annual appointments for you-- they send you a letter, and you have to call and make the appointment, which is fine, but I don't really want to go to the appointment even though I know it's a good idea to go. I need to do more to take care of myself, and getting to the doctor once a year really should be a part of that.

Except that I won't get to talk to a doctor, I'll get to talk to a nurse and if I'm really lucky a physician's assistant. There will be the same questions: do you drink, do you smoke, do you use, etc. I'll answer no to all of the above, and they'll look at me like I'm lying-- they know I'm a veteran with PTSD-- and I'll say "really, I don't drink. Maybe one beer in six months" and they'll shrug and get on with it. They'll weigh me, and take my blood pressure and pulse, and I'll get sent across the hall so someone can take blood.

They'll ask about how my medications are doing, and I'll explain that one of the pills they tried to start me on last year made me throw up without fail, so I stopped taking it, and that no one has followed up since. I'll keep talking and explain that they need to find something, even if it's not as effective, that doesn't make me throw up and then we can work from there. Last time I suggested that, they prescribed medication for acid reflux-- an annoying problem to be sure, but not a solution for pills that make me throw up whatever I eat.

The nurse or PA I talk to will be someone I've never met before, and I won't bother learning his or her name because I won't see them again. They'll have rotated out before I'm back in primary care again. For this appointment, they'll have looked at my records for maybe a few minutes ahead of my appointment, if that. They'll probably give me some new pills after my blood work comes back from the lab, and even though I told them that it's much better to contact me via the VA's online secure messaging system they'll call me at 0900 some morning and leave a message with no information. The new pills will come in the mail. Maybe they'll help, maybe they won't.

To get to the primary care clinic, I'll have to take a bus that will take almost an hour to get me there and an hour back, even though geographically it's not that much farther away than the VA Hospital (which is much faster and easier for me to get to). I'll ask why I am moved every year to the satellite clinic, I'll ask to be moved back to the main hospital (where the mental health clinic is), and no one will give me a reason why this can't happen.

The primary care clinic is busy-- the waiting room is almost always crowded and noisy. Without fail, someone will say something about my field jacket or my backpack or something. I'll see someone I know from transitional housing, or someone I know from being on the street. Maybe I'll see a person who recognizes me from when I was in VFW, or someone from VFW will see me and not recognize me but see me as a potential new recruit. Madison is a small town, the community of vets even smaller. It's always someone who says something, and I'm not happy being at the clinic to begin with, and so I'm not much for conversation.

Pro tip: don't approach me about (re)joining the VFW. Ever.

My biggest fear is that in the waiting room will be one of the Porchlight staff from transitional housing-- one of the people that put me through so much shit and ultimately put me back out on the street. Since the day I left Porchlight, I've only come across one of those people, and my meeting with her didn't go well. I'm not sure how I'd react if one of them was sitting in the waiting room, there with another veteran. I know that I'd want to say something along the lines of "Oh, hi ____. Are you going to put that veteran out on the street and leave him to die just like you did with me?" Since the waiting room would be full of other veterans, this would likely fall under the category "causing a scene".

There's a VA Police (yes, the VA has its own police force) officer stationed at the satellite clinic. Causing a scene probably wouldn't be the best idea, I know, but PTSD plays this particular scene in my head over and over again and has since I was in fact put out on the street and left to die. That I didn't die was because of my efforts, not those of anyone associated with the VA, and I'm still a little ticked off about the VA never following up to see if I'm all right (the Vet Center here told me I was fine and that I didn't need their help-- haven't been back there since).

The last thing on earth I need (or want) is to find myself in a situation where the PTSD is doing the thinking and things are perceived to be out of hand. Just like the intern PA who doesn't know my story and doesn't care, the cop won't either. In reality, if I saw someone from Porchlight in the room I'd just let the front desk staff know that I'd be waiting outside and that they should just look for me there.

All of this put together doesn't make me especially excited about sitting at the VA emergency room all day (or night).

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I also haven't heard from the VA since I stopped going to the weekly prolonged exposure therapy booster group (which I stopped going to when I found out I was limited to attending six times in a six month period-- I'd already been there four times). I'm alternately confused, ticked off, and saddened by the lack of contact and follow up. You'd think that anyone who was going to a voluntary group for combat veterans with PTSD who just stopped showing up would at least rate a follow up call to see how things were going.

Guess not.

For the four times I attended the group, I met three different people running the group-- all of them interns. One of them has since moved on to a different VA facility. One was a guy who I'd never seen before, and probably will never see again. The third wasn't there most of the time, and she was supposedly the one running the group.

Talking to the other veterans in the group really did help, but since it was a drop in group the lineup of who was there changed every week. You'd start getting to know someone, and then not see them again for a couple of weeks (or again at all), and that gets frustrating instead of helpful.

I don't even know if the group still meets every week.


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If you're still reading, I probably owe you thanks for listening to me rant for this long. So, thanks.

I'm still going to rant, but I'll at least change topic now.

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It is also Halloween today this weekend in Madison, which doesn't help. Halloween here is a tradition that involves basically everyone dressing up in costume and going out and getting stupid drunk in the name of tradition. The city of Madison has tried to rein things in a bit, by closing off State Street for Freakfest every year. When Halloween falls on Saturday as it did this year, the party unofficially starts on Friday night. If you like this kind of thing, groups of loud drunk people roaming around your neighborhood all night yelling at each other, you'd be in the right place in my 'hood.

People drive for several hours to come here and be obnoxious for Halloween-- I did once, when I was a freshman at UW-Whitewater, so I understand the attraction. Halloween is one of those excuses to road trip to one of those legendary parties that you read about happening at places you're never at, so you want to be there.

Except that now I am there, and I rarely if ever drink, and loud drunk people are just stupid and annoying. My neighborhood is one of those places where you stay with friends who live in Madison when you come to visit, and so there are lots of loud drunk people outside my apartment.

This is why I'm tucked away inside a campus building writing and working, and not at home trying to sleep. There will be a short break, between maybe 0500 and 0700 when the streets will be quiet enough that I can sneak over to McD's for breakfast. Most of the lots set aside for tailgating open at 0600 or shortly after, so there will be the additional loud drunk football crowd and I'd like to avoid them if at all possible as well.

There are a lot of really cool things about being a student at a large state university, but so many things here are based around partying. I know, that's college. I've been there and done that, and had some really good times (and I even remember most of them). I'm not advocating prohibition here, but shit like half the city being drunk and stupid for Halloween because it's a 'tradition' isn't funny any more.


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