Advice on what to expect

Marine32

PEB Forum Veteran
Hello to all,

First off, I would like to thank Jason for creating this site as it is an excellent source for those of us experiencing the MEB/PEB process.

I am an active duty E-6 in the Marine Corps currently stationed in a remote location (Johnstown, Pa), so most of my medical issues have been handled by civilian doctors. Since being stationed here at Johnstown in October of 2005, I had a stress test done in June 2006 due to dizziness and lightheadedness (diagnosed with anxiety and put on meds), had right shoulder surgery in June of 2007 (reattached the labral to the bone and removed a cyst), had neck surgery in April 2008 (cervical fusion on discs C-5, C-6), had a stroke in May of 2008 (been on aspirin, meds for systematic hypertension, and meds for high cholesterol since the stroke), had a heart catheter done in August of 2008 to close the PFO/ASA in my heart, and been diagnosed with obstructive sleep apnea (getting fitted for a respirator on 21 Jan) in December of 2008.

I have always been a very physical Marine who has kept myself in shape… so I thought. I’m even a martial arts instructor. I’ve attempted to go back to work because I assumed I could make a full recovery. My neurologist stated that I could get up to 98% of my ability back because of the part of the brain the stroke affected, but after several months of attempting to recover, I’ve realized that it is going to take a lot more time than I realized. I worked with an occupational therapist for several months, and they helped me make a dramatic improvement with my right side (mainly my right arm), but I still have many fine motor skill issues. When I first wake up in the morning, I may be able to write a couple of sentences struggling. As the day progresses you’d be lucky to get a sentence out of me, as more symptoms come on with fatigue and tiredness. I attempted to come back little by little, I was then reduced to half days by my neurologist because he could see that work was interfering with my recovery, and then I was reduced to an as tolerated status by my PCM.

I recently went to an appointment for my limited duty evaluation and the Navy Lt. recommended me to for the VA/DOD Pilot Program. I have to attend my first appointment with my case worker and the VA rep on Wednesday the 21st of January. My wish is to not continue service because it is affecting my recovery. I’m not sure what to expect, which is why I’m asking for advice from anyone who can give it. I’ve listed all of my medical conditions below. I appreciate any advice given.

John

- L Knee surgery in Apr 2000 (meniscus)
- L Knee surgery in Aug 2000 (ACL Reconstruction)
- Stress test done in June 2006 due to dizziness and lightheadedness (diagnosed
with anxiety and put on meds)
- R Shoulder surgery in June 2007 (labral repair and cyst removal)
- Neck surgery in Apr 2008 (cervical fusion on C-5, C-6)
- Stroke in May 2008 (acute stroke in the medial and cortical aspects of the
cerebellum on the
right hemisphere and a very small stroke in the left occipital lobe)
- Systematic hypertension (diagnosed following stroke… put on high blood
pressure meds)
- Hyperlipidemia (diagnosed with high cholesterol following stroke… put on meds)
- Heart catheter in Aug 2008 (device placed in heart to close PFO/ASA)
- Sleep apnea in Dec 2008 (scheduled to be fitted for respirator)
 

robs42

PEB Forum Veteran
marine32,

welcome and sorry to hear about your medical situation. i like you have alot going on. back injury w/4surgeries, being treated for TBI, casue i've been having siezures/dizzy-spells, PTSD/anxiety/depression, and sleep apnea.

for the sleep apnea your getting a CPAP, right? if so get on it and stay on it. it's helped me ALOT. everyone i know that has one says that they don't like it, it doesn't work, but they don't use it. if they don't rate you on it, that's a battle that you can fight w/on the VA side w/an appeal. and i believe it 50% w/the CPAP.

w/the stroke, have you ever had a TBI screening along w/it? have one done. it can't hurt. when i had my 1'st siezure/episode that's what they thought i had. did the stroke hapen after the fusion? my neuro. issues started after my spinal fusion (l5-s1)

the bst advise i can give you is just to start educating yourself to the DES. stay ontop of all your medical documentation, ensure everything is properly documented and get copies of everything. one of the issues that you may unfortunately run into is a lack of education and support on the unit level. just hang in there and don't let them beat you down. the whole process is very frustrating @ times. that reminds me...are you having any mental health issues, since all this stuff happened? right after my 1'st surgery i started getting depressed and anxiety was through the roof. i started to an AD navy mental
health clinic. that didn't work out too well, so i started going to my local VA's Veterans Center for weekly sessions and i go to the VA's PTSD clinic now. it's really worked out well. so if you are having any issues, make sure that you address them. not just for the MEB and the rating but just for your overall halth.

i'm sure somew/will chime in w/more info.. but know that you are not alone here. everyone here is in the same boat. good luck and if you need any help along the way or just want to vent, i try and check in here every day. so just drop me a line any time.
 

Marine32

PEB Forum Veteran
robs42,

Thanks for the help. It seems that you have a lot going on too, but you are handling it well. To answer your question, yes I am going to be fitted for a CPAP on Wednesday the 21st of January. I do plan on using it, even though I'm sure my wife will want to kick my butt after having a sleeping machine.

I haven't had a TBI screening done yet. Who does the TBI screening? Is it too late for me since I have an appointment next week with my case worker and the VA rep? I would assume that I did have a tramatic brain injury since the MRI revieled that I had brain damage from the stroke. Besides, I still have fine motor skill issues with my right side. I'm wondering if I can be rated on TBI without a screening before I go to the board.

The stoke did happen within two weeks after coming back from the cervical fusion. I thought I was on the road to recovery after coming back from surgery. During the week before I had a stroke, It felt like someone was hitting in the back (felt like major bruising along my spine) with a baseball bat. I handle pain well, but this was unbearable. I went back to the neurologist who performed my surgery, and he said I may have other disc issues and to come back if the problem persists. I had a stroke a few days later.

I have been keeping good track of my medical records though. I just made two copies for my case worker, and a copy for myself. Each copy is 6 inches thick... a lot of crap. Anyway, thanks for the advice and I wish you the best of luck.
 

robs42

PEB Forum Veteran
marine32,

just incase you missed jason's post on strokes, i linked it here:

http://www.pebforum.com/va-news-feeds/9899-va-research-brain-body-retraining-after-stroke-01-17-2009-a.html

w/the TBI you can @ least get the screening done and file w/the VA after. all it is, is a series of questions regarding past injuries and head injuries, if you've been around blasts/explosions, been KO'd and if you have a positive screening then you meet w/a neuro. @ the TBI clinic (if they have one), my va does. i see him on the 20th so i will let you know how it goes. FYI...i had some clean mri's and xrays. had one abnormal eeg and one normal eeg.
 

CSM493

PEB Forum Veteran
Registered Member
Marine32,

The VA TBI clinics seem to focus on injuries sustained in combat or from trauma incurred during duty. It sounds as if you are saying your TBI may have been as the result of the stroke?

The VA will do the screening for you and then set you up with an appointment with a VA TBI clinic. These guys are really pretty good but it is a new science for them. I have had MRIs/cat scans, etc in addition to two rounds of neuro testing, advanced balance/coordination testing and numerous others. I am still being rated for it.

But as far as the sleep apnea, I got 50% right off the bat.

Good luck, Marine!

CSM
 

Marine32

PEB Forum Veteran
Thanks for the info on TBI, both of you have provided excellent advice. And yes, all of my TBI issues are a result from the stroke. Sounds to me that VA will probably be where all of my medical needs are transfered as I go through this process. The corpman at my command did say that my final destination will be near a VA hopital, so they can provide me with medical care.

A few people have said that sleep apnea will be rated at 50% (as long as you are on a CPAP), but I guess that they don't see that as unfitting alone. I don't think I am worried because I have several medical problems that I believe to make me unfit, but it seems like they don't just let you go without a fight, so if it is possible to make me fit they will. The only question I have is- will they rate me on the previous surgeries I have had? I haven't went to medical and complained about them every time they hurt, so I don't want them to just overlook my past injuries because of that. I'm speaking mainly of the two knee surgeries (meniscus, ACL reconstruction) I had back in 2000. I did see the navy doc in Okinawa, Ja just before I came to Johnstown in 2005, and they did x-rays and MRI's, but they said I may need additional surgeries that would be taken care of at my next command. Last I heard about it. Since I limited my physical activity, it didn't bother me as much, but since I've had a stroke, everything seems to bother me. Sorry for rambling on and thank you both very much for the advice. robs42, thanks for the link on strokes... it was very informative.
 

Jason Perry

Benevolent Leader
Site Founder
Staff Member
PEB Forum Veteran
Registered Member
Marine32,

I appreciate the thanks, I am glad to help where and when I can!

As for rating your "surgeries" remember, that a surgery is a procedure, not a condition, so having them won't result in a rating unless they result in a complication or the underlying condition is not improved. Painful scars can be rated, but this is pretty rare and remember would not likely be "unfitting."

What you really need to look at is if you have residual or uncorrected limitation of function. This may be a basis for a rating (more likely at the VA, but if they have gotten worse, could be unfitting and then would be rated by the Dept. of the Navy).
 

Marine32

PEB Forum Veteran
Thank you for your quick answer Jason. It makes sense that a complication that results from a procecedure would be ratable. I would think that my knee has given me complications, especially after the stroke. Maybe because I had to compensate for my loss of motor skills on the other side of my body. I definatley have pain resulting from the procedures done, and have issues with stability whenever my knee is in any position other than locked out. It mainly affects me when I am climbing stairs or attempting to do something physical. Also, I've had problems with my neck (pain and ROM) since I had cervical fustion done in Apr of last year. I imagine part of the reason is because I had a stroke a month and a half after the surgery, so I never really had time to focus on my neck recovery. Again, thank for the info.
 
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