Talk about Catch-22 upon Catch-22, cancer style! I initially elected "watch and wait" on my cancer,
but it seems I was doing the waiting, and nobody was doing the watching for me even as my PSA numbers went up and alerts from the lab went out.
Watch and wait turned into a spreading cancer addressed far too late.
On my own and through a civilian urologist, I asked for a biopsy after a year or so had passed since the last one at VA Portland, but it was too late to be as helpful as it might.
I asked the 800-number for VA's Choice Program for local surgery for aggressive prostate cancer, but was immediately turned down. Seems I live within the 40 miles from a local VA day clinic so Choice Program determined me "ineligible."
Even though my Fort Collins VA day clinic does no surgery at all, the VA rules are that outside care is only permitted if no VA facility exists within a magic forty mile circle from one's home.
It doesn't matter whether the nearest VA facility provides that, or any other service...if it exists within 40 miles, under its Choice Program a veteran can only get non-existent VA treatment and not outside contracted care...read: "Do without."
So carrying the conversation further, I inquired about prostate cancer surgery at the nearest VA hospital, which is Cheyenne. They explained they don't do that procedure any longer, and that they refer patients to local providers. Probably, the same ones I wanted VA to send me to in the first place!
BUT...I'd have to wait at least a month to see a VA physician in Cheyenne for the necessary referral, then wait whatever time is required for an appointment with the referral surgeon, and then get the operation scheduled someday in the future.
Problem: Stage Three cancers don't wait. Certainly, not the three months or even more VA requires to begin treatment for cancer already spread past the prostate. I didn't want to wait three months for the cancer surgery, which we now know would have been three months for the cancer to continue spreading. So, like many other 100% service-connected veterans eligible for non-existent (or at least, very hard to get) care at the VA, I was forced to fall back on other options.
I also believe the VA's limit on a vet seeing one's primary care provider but twice a year played a harmful role. As a veteran already rated 'catastrophically disabled" its hard to see how all the issues at hand can be addressed in two face-to-face meetings a year.
When I asked about trying to see my wonderful VA primary care provider earlier as problems arose, I was told instead to go to the Cheyenne, Wyoming VA emergency department, 50 miles away and difficult to get there with a wheelchair.
So instead, I sought out our local hospital's ER where I was treated for eye injuries, shoulder surgery, and probable hip replacement as well as non-urgent medical concerns for which I sought attention between the VA's six month visits.
For me, the system didn't work, neither for caring for me as the cancer started elevated PSAs nor for the surgery to catch it before it metastasized. For VA, it worked perfectly as designed...they saved thousands by building a health care system which avoids providing care. Especially in the case of C-123 veterans.