First VA appt while still on terminal leave

tony292

tony292

PEB Forum Regular Member
PEB Forum Veteran
so I kind of got tricked. Stationed in Nebraska (ROTC) and this VA DR kept calling me wanting to see me when I came to FT Riley to out process. This happened last week. She was very nice but a PHD LCSW.... Said she had worked mental health for years.. Asked me about my MH diagnosis, she thought I was still diagnosed with somatoform disorder, I had to educate her about the ten neurologists I've seen and that all ten had failed me. She questioned me about suicidal ideations, prescription meds and alcohol. She lectured me when I to,d her I was taking 3 prescription sleep meds, 2 anxiety meds and half a fifth of whiskey per night... She REALLY lectured me on the alcohol vs medications interactions, I shrugged it off and said I don't care if I live or die. I'm not suicidal at the moment, I simply don't care. So she got me a tricare referral to the VA (something I had never heard of). I think they want me to go inpatient. I just want to be with my family. She wrote this in my blue button... Can anyone decipher? "
Interviewed SM 12/4/15. He presented as a/o/x'4." I like to read and understand what doctors write about me, I don't trust doctors. They will look you in the eye and say one thing, while simultaneously typing notes into the computer stating the opposite... So:

"He presented as a/o/x'4." Troubles me greatly, as I cannot make sense of it. Any thoughts on what this means?
 
MEDICAL INFORMATION
Dx: Unspecified anxiety disorder with depression; Myasthenia gravis with restrictive lung disease; Myasthenia gravis with right lower extremity sciatic nerve involvement; Myasthenia Gravis with left
lower extremity sciatic nerve involvement; Myasthenia Gravis with right upper eyelid Ptosis; Myasthenia gravis with convergence
insufficiency. Medications: Mestinon 60 mg; Lunesta 3 mg; Remeron 10 mg; Gabapentin 100 mg. SM to obtain 90 day supply of medications prior to departing base. Interviewed SM 12/4/15. He presented as a/o/x'4. Self-care in all spheres, cooperative, engaging. SM
reported experiencing SI x one month ago. However he denied intent. He denied previous suicide attempts. There are no previous inpatient psychiatric hospitalizations. SM reported ingesting 1/2 pint of whiskey the night preceding his appointment with this provider and nightly.
For previous 2 years SM reported ingesting a fifth of whiskey nightly
in conjunction with sleep medications. "It helps me relax." SM
reported being aware of the dangers of mixing alcohol with sleep medications. SM advised of VA outpt, inpatient and extended care programs for substance abuse disorders. SM amicable to treatment. Illicit drug use was denied. SM shared he previously avoided
treatment as treatment would have impacted his plans to transition. There were no reported instances of MST. SM denied high risk behaviors.
 
tony292 said:
so I kind of got tricked...She wrote this in my blue button...Can anyone decipher? "
Interviewed SM 12/4/15. He presented as a/o/x'4." I like to read and understand what doctors write about me, I don't trust doctors. They will look you in the eye and say one thing, while simultaneously typing notes into the computer stating the opposite... So:

"He presented as a/o/x'4." Troubles me greatly, as I cannot make sense of it. Any thoughts on what this means?
Click to expand...
Indeed, I definitely agree; always verify what any medical clinician is annotating within your medical records for sure!

Basically, medical healthcare professional are trained to assess a patient’s level of alertness and orientation by asking them four questions: (1) Who are you? (2) Where are you? (3) What is the date and time? (4) What just happened to you?

To that extent, normally, we are awake (or we wake quickly from sleep), alert and we know who we are, where we are, the date, time and recent events. As such, this is described as A (awake) A (alert) and O (oriented) times 0, 1, 2, 3 or 4 if the patient knows who they are, where they are, what date or time it is and recent events.

For example, reference the following for a detailed explanation:
  • AAOX4 means the person knows person, place, time and event
  • AAOX3 means the person knows person, place and time, but not event
  • AAOX2 means the person knows person and place, but not time and event
  • AAOX1 means the person knows person, but not place, time and event
  • AAOX0 means the person is awake and alert, but is disoriented
Bottom line is the main usefulness of the aforementioned set of questions is that it is so standard. It tests mainly recent and longer-term memory, albeit as in all other parts of any medical examination, the response is also influenced by level of alertness, attentiveness, and language capabilities.

With that all said,, please take care and enjoy your forthcoming military retirement with your family! :cool:

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 
Awake Alert and Oriented (AAO)
x4 (person place time and event)

Nothing to be concerned about. But I agree that she should have been concerned about your meds combined with your alcohol intake.

Best wishes
Mike
 
You must log in or register to reply here.
Top