Any VA Hospital employee's here familiar with the system?

Valerie Salva, BSN, RN · Feb 19, 2010

I would think that the best thing to do would be to approach your doc again, telling her that this is very important to you, and you really want her to take some action on this. If she is a good doc, she will surely be responsive.

Michaelxy · Feb 20, 2010

Last month my blood results turned in a very high triglyceride count (650). My physician told me to lay off the sweets, even though I don't really eat any sweet foods.
This month I had to see an NP as the hospital was slammed, and my count was still up there at around 500. The NP thought I should have my pancreas checked out, but the physician dismissed it and would not put in the order.
Due to the way the VA works, I can't get in to see a different physician, I'm stuck with this one. Despite asking her to put the order in myself, she wants nothing to do with it.
Should I be a bit concerned? What do folks at the VA have to say about this? Aside from this incident my physician has been great, one of the best I've ever had - I don't want to get her in trouble over this.

I to use the VA as my medical care and have always thought the care to be very good. Albeit, I am not a physician, I tend to agree with your doctors decision as a high triG count is indicative of high amount of LDL attributed to poor eating habits. I would not suspect the pancreas unless you are a heavy drinker, in which case the pancreas is plausible.

DirtyBlackSocks · Feb 20, 2010

I to use the VA as my medical care and have always thought the care to be very good. Albeit, I am not a physician, I tend to agree with your doctors decision as a high triG count is indicative of high amount of LDL attributed to poor eating habits. I would not suspect the pancreas unless you are a heavy drinker, in which case the pancreas is plausible.

The service in the VA is excellent. I think I need to discuss my concerns further with my Physician as I am a transfer from a different VA due to a move.

The reason I hold concerns, is that at my other VA my triglyceride count was near 1000, and this is when I was fresh out of the military. I was a Ranger in the military - and in very good shape, with excellent eating habits. Due to disability's this fact has changed, and the notable decline in the count despite putting on weight and becoming sedentary is probably a good indicator that I should not be concerned.

The problem was not addressed at the last VA I was attending because there were more pressing concerns with psych and ortho at the time - and I couldn't fit seeing my primary into my schedule. Poor excuse, I know.

I was, however, a very heavy drinker in the military. On my first blood test after being released my physician told me if I did not quit drinking I would be dead in 10 years. Liver enzymes were through the roof.

Obviously this is an issue outside the scope of an RN - perhaps even an NP. I was just concerned that my physician was so inclined to flat out deny looking into it further. She is a new physician, very young, very enthusiastic - but I've noticed that she likes to avoid discussing complications I'm going to face down the road due to my disabilities - I don't think she wants to worry me anymore than I should be worried.

There are a lot of other medical problems I'm facing right now (possible necrosis of the femoral neck in my hip due to lack of blood supply, combat related psych issues, spinal stenosis) that the NP is not aware of - and perhaps my physician thinks they should take priority over something like this. All my other blood count readings are well within normal ranges.

If anyone has advice on how I should confront her with my concerns without offending her (I'm a very blunt person, and I often come off as accusative rather than concerned) I'd appreciate them.

If anyone also knows how I might go about getting a second opinion from another physician within the VA I'd appreciate it - from what I've been told by those I've asked within the VA, you're pretty much stuck with the physician you're assigned.

It also helps me to vent on here, as I don't want to worry my wife too much - so thanks for reading through it and providing any sort of input. Allnurses seems to be a new support structure for me. :)

Michaelxy · Feb 20, 2010

As I previously mentioned, I to am a vet and have used the VA for many years (Our one benefit for serving), I have discovered that much like the military, the VA goes by the book. There is a great deal of communication amongst the VA departments which is a good thing. You can't fart in the audiology lab without your pri-care physician hearing about it (No pun intended). As I am sure you know, many patients often lie when confronted by a medical person (Shame often brings this about), so I figure the NP was just covering the bases of possibilities in case you were not being entirely truthful. A simple blood panel would rule out the pancreas and I am sure the NP relayed any and or all results to your primary care doctor. Don't worry. your not falling through the cracks. The VA is the best and your in good hands. Hooah... I think that is what the Army says, I was Navy :) Arghhh... :lol2:

And for Pete's sake, wash your nappy socks. :)

DirtyBlackSocks · Feb 20, 2010

Thanks for your service Squid, and yeah it's Hooah

I'm well aware of how many Vets lie, which bothers me. I have to jump through so many hoops to get pain meds for my hip.

Trauma Columnist · Feb 20, 2010

I'm a vet too and I thank you both for your service. I (very fortunately) don't have any service-connected disability so am not eligible for VA care. However, I did work for the VA for several years and there is an official way to ask for a second opinion. I would follow that chain of command to get answers.