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Not yet sure what is going on
#102516 01/29/08 07:08 PM
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About 10 months ago I hurt my back while doing two boat towing training at the search and rescue station I work at. At first I thought I just pulled a muscle so I went up to our medical facility to check. The doctor said to take a few days to rest my back and to take some asprin, and to come back in a few days to follow up.
I went back and the pain did not subside at all, the pain was now spreading from the left tip of the shoulder blade down the left side and across the lower back to the right side. The pain was not just a pulled muscle pain but I was also feeling muscle spasms and moterate lower back pain. My doctor refered me to physical therapy. I was in physical therapy for about 3 months with the only thing that happend was more pain and I was able to strech my hamstrings. The physical therapist was completely baffled on what was going on. She noticed that I had extrem weakness underneath my shoulder blades and after doing the exercises for so long they were still not getting any stronger.
After physical therapy was done with my doctor started to dig a little deeper and found that I have a genetic disorder that I had less testorone growing up. She also found that I could have a heart murmum. I was able to go to Madigan Army Center in WA to see if they could figure out what was going on. Nothing was found, they said welcome to 50% of americans with back pain and I would have to deal with it. The geneticist I saw explained the disorder and also siad that it sound not contribute to the pain I was having. I went back to Ketchikan were my doctor tested for everything; lime disease, all th forms of muscle dystrophy, I had bone scans, mri, xray, and I even saw a nueroligist with everything coming back to nothing wrong.
At this point it was not just back pain any more it was effecting my entire left side; neck, shoulder, arm, hand, knee, hip, foot, and it was exterem pain when i do anything there is no relief. I'm now 5 months into a medical board which is slow and it seems like i'm in the dark about everything. They keep telling me that I will be either on the TDL or PDL and they don't even have any Diagnosis besides a back ache.
If anyone has any suggestion I would really appricate your response.


Brian W Greathead
Re: Not yet sure what is going on
#102517 01/30/08 04:23 PM
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I was reading through the statment above and I just what to list all my symtoms. severe back pain form just below my left shoulder blade down to my butt and across to the right, also stiffness and numbness and tingling into my hips. My neck feels like I can only move it 2-3 inches left or right (really stiff), I have numbness and tingling into both shoulders and down into the elbow and countinueing down into my hands. I have severe tremers in my hands and sometimes I can't grab things because my hand completely lock into a cupping postion. Every day I wake up my joints pop and snap like there out of place, some hurt alot both others not at all. In my hips sometimes it feels like they pop out of place and its difficult to walk and put pressure on it. I have numbness and tingling from my hips into the back of my knees, then it splits and seems that one goes into the top of my foot and one goes into my heal. My knee tend to swell if I do stairs. Every where I have mentioned I have severe muscle spasms all day with no relief. I'm 21 years old.
??????????


Brian W Greathead
Re: Not yet sure what is going on
#102518 01/31/08 03:53 AM
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so sorry to hear you are in such bad shape! keep on the docs to get you diagnosed and make sure you get COPIES of ALL your medical records..

complain...
complain...
complain...

hopefully someone else here will have more advise for you...


~ Trudi
35 yo mum to 5 kids!
dx with 'probable AS' in the middle of 1995 in the Navy. positive inflammatory spondyloarthritis dx by the end of that year. no meds really work yet. am trying sulfasalazine plus a lot of alternative therapies.
www.madebytrudi.blogspot.com
Re: Not yet sure what is going on
#102519 01/31/08 03:50 PM
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thanks for the post Trudi! I won't give up its all i got right now, being in the military.


Brian W Greathead
Re: Not yet sure what is going on
#102520 01/31/08 08:44 PM
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make sure you get a good rep too before signing any papers for med boards. I got scr3wed by signing mine without a real diagnosis of my problems....I was in pain and wanted to get out at the time and didn't care or even think of any future ramifications that piece of paper would mean later in life...


~ Trudi
35 yo mum to 5 kids!
dx with 'probable AS' in the middle of 1995 in the Navy. positive inflammatory spondyloarthritis dx by the end of that year. no meds really work yet. am trying sulfasalazine plus a lot of alternative therapies.
www.madebytrudi.blogspot.com
Re: Not yet sure what is going on
#102521 02/11/08 05:04 PM
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I went to the doc the other day because I was having another crazy symtom. It start about a week before and I would just be relaxing in a chair or in a sitting postion and after about 30 minuties or so I would try to get up I could not walk I would be bend over and could only take shuffle steps. The doc told me that I was over weight and that not only this pain was coming from that but all of it was. Can you believe that! I'm just at a lost for words at tis point in time, advise would be helpfull thanks.


Brian W Greathead
Re: Not yet sure what is going on
bgreathead27 #104383 03/04/08 05:36 PM
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Hey Everyone,
Well the the same old things are happening here in ketch. It's been just under 6 months into my medical board and there still dragging there feet. It's driving me insane. It started with the sector comand wich is in charge of our station. My medical package sat on the Capt. desk for two months just to get a endosement and then be sent to the District, were the Admiral had to sign in. It was only at District for a week though but the retarted thing they did was they sent they unfinished package to headquaters after that. Once it got there they to one look at it and made the nessesary phone calls to get the ball rolling. (thank god for good yeoman) The package was sent back to ketchikan on the 8th on Feb as I thought.... but I was wrong again being that it's Alaska the mail is not the fastest in the world, after a week with DHL it was not here I start to look in to it thourghly and it didn't get sent! Once the package was sent it got here in two days but was hidden on base at the warehouse for three days. It's like the whole world is against me or something.
Anyways I got the package and come to fine out that the whole time it was in sector/district to get an endosement they just signed off on my commanding officer's.
I Mean ....... what can I say about that what a waste of time.
The package is now put togeather and being sent to headquaters so we will see what happens right. Thanks for listening and sorry for rambling on and on.
Brian


Brian W Greathead
Re: Not yet sure what is going on
bgreathead27 #106234 03/20/08 04:32 AM
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it's all the same... hurry up & wait!

hang in there! it will soon be over!


~ Trudi
35 yo mum to 5 kids!
dx with 'probable AS' in the middle of 1995 in the Navy. positive inflammatory spondyloarthritis dx by the end of that year. no meds really work yet. am trying sulfasalazine plus a lot of alternative therapies.
www.madebytrudi.blogspot.com
Re: Not yet sure what is going on
TrudiD #111086 05/14/08 07:01 PM
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Heres an update on the old situation. There not sure what was going on so, they sent me for a psych eval and it came back as conversion disorder. I find this had to believe because the dr said he couldn't believe they sent me for the eval in the first place. I had a normal life growing up and nothing to suggest the disorder besides the fact that they can't figure out what is causing the pain. I'm suppose to hear what they are going to rate me with by the end of the week, so we will see right. Any suggestions on what I sould do? Is this disorder going to mess up my civilan life, with getting a job?


Brian W Greathead
Re: Not yet sure what is going on
bgreathead27 #111213 05/15/08 10:52 PM
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Pardon the intrusion as I am not in the military or a veteran but it sounds like another case of "we don't have a clue so you must be mental" to me. An oldy but a goody. I hope you find a cause for all your pain.


Jill
37, mom of three
Houston, TX
Re: Not yet sure what is going on
justice #111216 05/15/08 11:18 PM
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I agree with Jill. Like they used to blame ulcers on stress until they found out that they are actually caused by a bacteria. Oops!

I hope that both you and Jill get an accurate diagnosis and help with your pain soon.

Brenda



Brenda

undifferentiated spondyloarthropy, HLA-B27+, iritis, Vit D3: 6000 IU/day, trochanter bursitis, Joint Hypermobility Syndrome, migraines, SI joint dysfunction/hypermobility, DDD L4/L5 and L3/L4, straightening of cervical spine, impaired glucose tolerance, sleep apnea.
Re: Not yet sure what is going on
justice #111793 05/21/08 06:42 PM
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Well I got some kind of result (even though its crap) they are saying severance pay at 10%. I totally don't agree with the results! What do you think I sould do?


Brian W Greathead
Re: Not yet sure what is going on
justice #112810 05/29/08 05:36 PM
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This is what the doc was trying to say after the psych eval, does anyone have any suggestions on how to handle this.
DIAGNOSIS:

Axis I: (300.11) conversion disorder, with mixed presentation. As manifested by onset of sensory motor deficits, muscle spasm, and tremor suggestive of a neurological medical problem following a back injury at work, association with psychological factors related to his back injury, no clinical evidence of intentional production of symptoms, symptoms that are not fully explain by presence of a general medical condition, and symptoms that cause clinically significant distress and impairment in occupational functioning.

Axis II: No diagnosis
Axis III: No diagnosis
Axis IV: occupational and family stress
Axis V: Global Assessment of Functioning
Current: 51-60 Moderate symptoms, moderate difficulty in social and occupational functioning.


Approximate date of origin: Winter of 2007
Incurred while entitled to base pay: Yes
Existed prior to service: No
Permanently aggravated by service: N/A
Impairment for further military duty: Marked, especially sea duty
Impairment for social and industrial adaptability: Definite


CURRENT FUNCTIONAL STATUS:

IMPACT ON DUTY: This service member’s ability to perform his assigned military duties is negatively impacted by his psychiatric condition

STABILITY: His condition has been progressively worsening over the past 12 months.

PROGNOSIS: Indeterminate, the service member has not been receiving any type of mental health treatment for his condition.

COMPLIANCE: This service member appears compliant with his established somatic treatment protocols. He has not been treated by mental health services in any capacity.

GEOGRAPHICAL ASSIGNMENT CONSIDERATIONS: Due to his psychiatric condition, this service member is not fit for worldwide deployment, and his ability to adequately perform his assigned military duties in negatively impacted in any duty assignment.

COMPETENCE: He is competent to manage his fiscal, administrative and logistical affairs.

SAFETY: He does not appear to pose a risk of imminent dangerousness to self or others.

CONCLUSIONS: This service member is medically disqualified for continued Coast Guard Service in accordance with COMDT Instruction M6000.1C, “Medical Manual”, Chapter 5, Section (B)(12)(a)

RECOMMENDATION:

CLINICAL DISPOSITION: The service member should continue with somatic treatment of his physical complaints with primary care as scheduled. He should be engaged with mental health services to address the underlying intrapersonal conflicts leading to his disabling medical problem.
ADMINISTRATIVE DISPOSITION: This service member should be processed in accordance with Physical Disability Evaluation System, COMDTINST M1850.2

HISTORY OF PRESENT ILLNESS: This service member was in his usual state of uncompromised health until approximately one year ago, when he injured his back at work during small boat operations. Review of his available medical records indicate that he had " a history of recurrent episodes of back problems through his teenage years," but nothing that medically prevented his initial accession into the Coast Guard.

Immediately following his injury, this service member began to experience pain in his back. Over time, this pain progress up his spine into his neck and shoulder, as well as down his spine into the back of his legs and his quadriceps. He described a progressive course of pain, muscle spasm, numbness and tingling which eventually included tremors of his hands. He reports now that he has swelling of his lower extremities after walking short distances, left greater than right. Further he stated that he used to swim competitively, but now even entering the pool makes his lower extremities “numb.”

The service member has undergone extensive physiologic workup to address his somatic complaints. No medical explanation has yet been found to adequately explain his clinical symptoms. The patient indicated that, all things being equal, he would prefer to stay on active duty with the Coast Guard and that he likes his job. However, in light of his subjectively experienced physical limitations he does not believe that he is medically able to complete his assigned military duties.

SOCIAL/DEVELOPMENTAL HISTORY: This patient was on May 27, 1986 in Pepperell, Massachusetts. He is the second of 4 sons, born to an intact married Union that remains together to this day. He described it emotionally supportive environment growing up, free of any overt abuses or neglects. He is a high school graduate, finishing on time with no skipped a repeated academic years in 2004. He entered the United States Coast Guard shortly after high school graduation. He is single, never married and has no children.

PHYSICAL EXAMINATION: limited to the mental status examination

O: MSE: Appearance: Well-developed, well-nourished, Caucasian male wearing a well-maintained, clean Coast Guard uniform, consistent with his social and occupational norm. He was sitting comfortably in an examination office in the Department of Psychiatry, Madigan AMC. He was neat, clean and well groomed with good attention to his personal hygiene. He was alert and oriented to person, place, time and circumstances of this assessment. Behavior: He was calm, cooperative and interactive with the examiner. Speech was normal to rate, prosody, tone and volume. Eye contact was appropriate. Mood was described as “O.K.” with a mood-incongruent, guarded affect (limited range and reactivity). Tp were linear, logical and goal directed, organized with good capacity for abstract thought. Tc was stated to be free of any suicidal or homicidal thought, intent or plan. He denied any hallucinations, delusional thoughts, inability to distinguish reality from fantasy, expansiveness, racing thoughts or any other clinical evidence of psychosis or manic illness. Judgment was fair, given his willingness to participate in this assessment. Insight was broad. HCF was grossly normal. Estimated intelligence level was average. Impulse control: good at the time of assessment


Brian W Greathead
Re: Not yet sure what is going on
bgreathead27 #112846 05/29/08 11:19 PM
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Hi Brian,

I am a military spouse (husband is a Navy chaplain). I have a background in clinical psych (worked as a therapist for about 6 years), and I was interested in a few things. First, who referred you for a psych eval? From what I understand through my husband, when someone gets sent for an eval, there needs to be a diagnosis. I don't know if this is consistent with the Coast Guard system since I hear more about Marines and Navy, but it seems that my husband and the docs talk a lot before sending someone in for an evaluation. Was it a psychiatrist who diagnosed or a psychologist? It can change how someone is seen in the diagnostic process. Also, I would imagine that there was some discussion between the person who referred for the eval and the person who did the eval; that could have influenced how you were seen. Have you been sent to a rheumatologist at all? It took a long time for me to get my diagnosis, and I had several Navy docs (who I liked personally but knew were completely clueless and grasping...but not required to get a diagnosis since I was a spouse) come up with absolutely meaningless diagnoses (my favorite was fever of unknown origin). Conversion disorder does exist, but it is not very common. Have you read about it in the DSM-IV? The more you can document against the diagnostic criteria, the better you can argue the current assessment. On a side note- why was there not an Axis III diagnosis?? (medical issues)

Laura

Re: Not yet sure what is going on
MomtoRhi #112893 05/30/08 11:26 AM
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Brian,
You definitely want to appeal to the FPEB. You will want to get any additional medical information you can to explain to the fomal board why you felt you were not given the proper rating. You will have an appointed CG attorney during this process. I agree with MomtoRhi (Laura), you should be sent to a rheumy doc also. I fought several flare-ups until finally a civilian optomologist had my blood tested for HLA-B27, which was positive. Then the Navy rheumy and CG docs finally agreed I had AS. Good luck fellow coastie.
Ray

Re: Not yet sure what is going on
RayH #112895 05/30/08 11:31 AM
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Brain,
Have you been over on the PEB forum yet? If not here is the link,
http://www.pebforum.com/
There is a lot of good people there that have excellent words of wisdom about going through the MEB process. It is moderated by Jason, a retired JAG.
Ray

Re: Not yet sure what is going on
RayH #112954 05/30/08 03:47 PM
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Ray/Laura,
After being in the medical board for around 6 months, the formal board requested a psych eval with a Psychiatrist because there was no dianosis found to explain what was going on. I have not seen a rheumatologist at all that pretty much the only doc I haven't seen. I just yesterday had the blood test for HLA-B27, so in alaska I will hear in about 2 weeks. I have been reading up on the disorder but to me it seems like a catch all for not knowing what is going on with me. The symtoms fit but the backgroud is way off. Ray I'm still waiting for the fullpackage to get here so I have to wait to talk to CG legal. I even have a friend in the VA to haelp me with my case so I'm off to a good step right? Again I apprieciate the help its been a long 16 months of this crap.


Brian W Greathead
Re: Not yet sure what is going on
bgreathead27 #112976 05/30/08 09:19 PM
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Brian,
Hang in there. I know from personal experience, the MEB can be a long, painful, and drawn out process. Hopefully the docs can get something figured out.

Ray

Re: Not yet sure what is going on
bgreathead27 #113045 05/31/08 12:52 PM
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Hi Brian,

It is important to remember that the diagnoses in the DSM are only categories created to understand clusters of symptoms. Conversion disorder is one of those often used for a "we don't know what else to diagnose because the patient doesn't fit anywhere else but does have symptoms". It can be a damaging diagnosis because it says little about what is truly happening (and offers no clear treatment). Keep documenting, pushing for skilled specialists, and taking care of yourself. All it will take is one knowledgeable person who is connected to your case to get it moving in the right (and helpful to you) direction. Also, I imagine that it creates less accountability of care if "they" can put you in a mental health category than a medical one. As much as it would be bad news in many ways, I hope you get a positive result for the HLA-B27 blood test to start getting the proper treatment. Hang in there!

Laura

Re: Not yet sure what is going on
MomtoRhi #114093 06/09/08 04:47 PM
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good morning,
Well it sucks to say but my HLA-B27 test came back negative. I also finally got the package with the findings in it. I'm waiting to talk to a lawyer about it. I'm also planning to take some leave so hope fully nothing will interup that. Who knows whats going to happen, but I do know thats its going to be an up hill battle to get any change.


Brian W Greathead
Re: Not yet sure what is going on
bgreathead27 #114097 06/09/08 06:25 PM
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I am sorry to hear that Brian! The small token of proof from positive result would have gone a long way. I think talking with a lawyer is a good next step and getting in to see a rheumatologist as well. Since I was pretty progressed when I got my diagnosis (that was found unintentionally when a CT scan was done for something else), I do not have much knowledge about the medical piece of things. However, I can tell you that the Psych eval was not done as well as it could have been. Getting a second psych opinion might be something to discuss with a lawyer - maybe not an eval but longer term observation in sessions that could dispute the conversion disorder diagnosis (of course, that would mean finding someone who knows something about health psychology/chronic medical conditions). The military is hurting in so many ways right now between the number of docs who are deployed to the number of service members malingering to avoid deployments; don't let go of anyone "official" who gets on your side during the long haul you have ahead of you.

Keep us posted,
Laura


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