Will there be more action taken? The Pendulum of Chronic Pain in the Military

COL Mikel J. Burroughs — Tue, 25 Aug 2015 11:14:38 -0400

Will there be more action taken soon? The Pendulum of Chronic Pain in the Military

https://www.linkedin.com/pulse/pendulum-chronic-pain-military-kimberly-bolen-rn-lnc-acm-ccm?trk=pulse-det-nav_art

By Kim Bolen RN CCM ACM This is Kimberly's most recent article and response from one of her followers on LinkedIn:

Len Swanson: Kim thank you my valent GETI Warrior, we can only hope that the political agenda the GETI Group is pursuing actively Sept 8th on with the return of the Senate (https://t.co/Ydr3h0R0cV) will turn the tide on Congressional callous indifference to what you always have pointed out and is once more reflected in this article.

I look to press Secretary McDonald when I am in DC during this period to adopt the GETI Group's 3 Pillars of Transition (https://lnkd.in/eWDBnYu) that shows the VA of "How TO" actually do VA Transitional programs as he has until November 1st in which to report back to the Senate (H.R. 3236) on how he plans to actually and effectively enact the Choice Care Act which the VA as you know has failed to do to date.

We can only hope we can win the day and if not with November elections on the horizon many Senators and Representatives will most likely be forced into early retirement by the power of the ballot. There is something to be said about 22 million pissed of Veterans plus their family and friends that just may sway votes in the end.....Enough is Enough

Response by LCDR Rabbah Rona Matlow made Aug 25 at 2015 11:26 AM

LCDR Rabbah Rona Matlow — Tue, 25 Aug 2015 11:26:41 -0400

As a chronic pain sufferer, I am all too aware of the shortcomings in treating chronic pain. There are a number of issues, some political, some medical and some military cultural, all of which combine to make it really hard.

Regarding cultural, is the phenomenon I call "Huah Huah three bags full." Military folks are taught to "suck it up". So when they get hurt, they don't get help, they suck it up. This just aggravates problems, and causes them to cascade to more problems, including both physical and mental. As an adjunct has been the problem in combat of unit corpsmen treating their squad mates, but not documenting the injuries, making it harder to get treatment and compensation. This then is exacerbated when the active duty person becomes a veteran and tries to seek treatment or benefits.

Governmentally are issues including budget. As I have noted in other threads, Congress is not willing to pay for the destruction caused by 15 years of war, and so both DOD healthcare and VA (all branches) remain chronically underfunded. This results in lack of capacity at VAMCs and MTFs, increased costs and further exacerbations.

Then there are medical issues surrounding chronic pain treatment. Opiates are very effective at treating many types of chronic pain (but not neurological pain, however) but they are addictive, cause constipation, depression and respiratory suppression. All of these can put patients at risk. Because of these risks, the DEA/FDA have greatly throttled the use of prescription narcotics, resulting in far too few providers who will write for them, for fear of losing their licenses - a tie back to government of course.

There is an option out there - the human body has receptors for canabadiol (CBD), the analgesic component in marijuana. In England, they have a pill form of CBD, which has no THC - the psychoactive component of marijuana. But our Prohibition minded Federal government won't allow CBD products to be produced medically in the states. CBD by itself is neither addictive nor psychoactive, making it a great pain medicine. In states with medical or legal recreational marijuana, it is possible to get strains with high CBD and low THC. The problem is still that THC is present, limiting its use as a pain reliever. Further, the most effective way to use pot is to smoke it, in current forms, and that adds further issues.

So active duty can't access it at all. Veterans in states with legal medicinal marijuana can use it and not jeopardize their status with the VA or private pain providers, but it's still a limited therapeutic because of the issues I've outlined.

It's time to get Congress off their duffs and get them to fix these issues, so vets and active duty folks don't have to suffer so much...

BTW, #NoIncumbentsIn2016 ...

Response by CMSgt Mark Schubert made Aug 25 at 2015 12:31 PM

CMSgt Mark Schubert — Tue, 25 Aug 2015 12:31:18 -0400

While I 100% agree that a veteran would be much more likely to have chronic pain and therefore prescribed opioids, there's a right way and a wrong way to do that - and the VA has been doing it wrong (in general) and it needs to be fixed. The correct action is not to "just stop" and I don't think that has happened across the board, but I do think the DEA has implemented some recent restrictions that are warranted and veterans who are receiving these medications should have no more of a problem complying with "required proof" than they do showing their ID card to buy beer - which I could never understand why anyone would get upset about that anyway!

http://www.usmedicine.com/agencies/department-of-defense-dod/legislators-call-on-va-to-stop-over-prescription-of-powerful-painkillers/

Legislators Call on VA to Stop Over-Prescription of Powerful Painkillers

By Sandra Basu WASHINGTON — In the wake of accusations that veterans are over-prescribed powerful painkillers, a House of Representatives subcommittee chairman called on VA to adopt more effective …

Response by Sgt Tom Vaughn made Aug 25 at 2015 1:07 PM

Sgt Tom Vaughn — Tue, 25 Aug 2015 13:07:21 -0400

I'm a chronic pain sufferer , the VA doctors informed me. That they can not be an advocate for any of us when it comes to the government , such as social security disability , or VA benefits .
So they just keep giving me pain pills , always telling me they want to fix the problem , but won't do anything .
The VA takes MRI/CT's. , then tell me nothing. They have 2 page reports to send to outside doctors , who do the MEIs over and have different findings .
As for the non THC drug ? Hey if it works I want to try it , but forget the VA from doing anything .

Response by LTC Stephen F. made Aug 25 at 2015 1:16 PM

LTC Stephen F. — Tue, 25 Aug 2015 13:16:30 -0400

COL Mikel J. Burroughs I have been a chronic pain suffer since June 1, 2008 when I had the unique privilege of having botulism and diverticulitis simultaneously just after I transferred to the Retired Reserve. My wife and I were on the way to a graduation ceremony of medical doctors who had just completed the requirements for Internal Medicine in addition to their previous specialties. Even though I was very sick it was marvelous to watch many doctors giving me advice.
I have been treated many opiods over the years starting with Demerol in 1972 later morphine many times, Dilaudid in surgery and afterwards. I generally avoid the opiods primarily because of their side effects including itching and constipation as well as hallucinations.
As a chronic pain sufferer I appreciate changes in pain and different types of pain which can be refreshing after experiencing daily pain and night pain. I hope and pray that the veterans who are suffering chronic pain especially severe chronic pain will experience relief without reliance on opiods.
I have been using non-opiod pain relief for 7 years - personally I don't get much benefit from tramadol but understand many do. I have had significant benefit from a combination of neurontin and acetaminophen with much less side effects. However I do take two does of both colace and psyllium every day.
In the military of the 1970's and 1980's we were taught to grin and bear it. Sick call was generally frowned upon by the rank and file although that was not the official position of the Army. I was glad to see a shift in the 1990’s towards preventative treatment which alleviated the stigma of going on sick call - at least where I was.

Response by SGM Steve Wettstein made Aug 25 at 2015 1:28 PM

SGM Steve Wettstein — Tue, 25 Aug 2015 13:28:58 -0400

You know Sir, I keep reading about all of these doctors over prescribing pain meds. I have had 13 surgeries. A total of four on my back with two of them being spinal fusions. Had a reconstruction of my right shoulder. I have limited range of motion with both shoulders and am treading water until I get them replaced. I pretty much have to beg to get some pain meds and the doctors act like I am trying to game the system. I have taken either or both muscle relaxers and some type of pain med since 2000. I don't see me being able to be off them unless some miracle happens and they can fix my back and shoulder.

Response by MAJ Ken Landgren made Aug 27 at 2015 12:14 PM

MAJ Ken Landgren — Thu, 27 Aug 2015 12:14:11 -0400

There are veterans with broken minds and bodies. They heal but never to 100%. They think about what once was, and now what is. Some will fight this protracted battle, and some will accept this is as the pinnacle of their recovery and accept it. Some will never get out of the hell on earth and will opt to commit suicide to end their pain, but the pain does not end as family members are now feeling the void left by their loved one. Keep fighting and never give up. Anyone can contact me if you need a mentor................

Response by CW3 Private RallyPoint Member made Aug 27 at 2015 6:00 PM

CW3 Private RallyPoint Member — Thu, 27 Aug 2015 18:00:50 -0400

COL Mikel J. Burroughs this article is a sobering reminder of some of the issues affecting service members across the services past, present, and future. Bottom line, chronic pain is a reality of service members, our chosen occupations are often not conducive to us protecting or conserving our bodies. With this in mind, there are major issues that need to be addressed individually by each service pertaining to the risks service members face, politically especially by the VA, and across military culture starting with front line leaders. Efforts to help those suffering from chronic pain our important and those current soldiers suffering along with veterans deserve help. However, these actions are reactionary in nature. More proactive measures need to be researched and implemented for the future.

Response by PO1 John Miller made Aug 28 at 2015 4:10 AM

PO1 John Miller — Fri, 28 Aug 2015 04:10:21 -0400

This is why I am an advocate for the federal legalization of marijuana. Personally I believe that it should be legalized not just for medical usage but for recreational purposes as well (but that's a different story). I have talked to many legitimate medical MJ users who have said that it has helped with their chronic (see what I did there? LOL) pain issues as well as alleviate PTSD symptoms.