Surprise - I've learned my most recent disease is Agent Orange related!

Bone death caused by failed blood supply

Not good news. I was diagnosed with avascular necrosis (AVN) last October, and yesterday learned that it frequently is associated with Agent Orange exposure. It is not on the list of illnesses automatically associated with AO by the Veterans Administration but medical experts connect the two.

AVN is bone death. Usually with AVN the blood supply fails for a major joint such as the hip, leading to bone death and eventual collapse of the structure. It can affect more than one joint and in my case, it has claimed two hips thus far but it seems my knees are okay. These are problems that can be addressed by hip replacements and the results are usually excellent. The new hip I got last Monday is working just fine!

I previously was treated with prednisone for two years by the VA, and prednisone is associated with about a third of AVN cases. There's a link there, but there is a link also made by medical experts to dioxin exposure. Dioxin can cause problems with blood supply to large bones - impaired blood supply to bones can cause AVN, and thus the necessary nexus.

It wasn't until yesterday that I discovered many cases where veterans had claims for AVN Agent Orange denied by the VA but approved when they appealed to the VA's Board of Veterans Appeals! These veterans were successful in their claims by providing several doctor's statements that dioxin exposure can result in impaired blood supply. In the BVA's finding, they summarize the doctors' letters:

 H. R., M.D., wrote the
following year that one of the etiologies of avascular
necrosis was ischemia to the femoral head due to
angiendotheliomatosis, which is one of the causes listed on
Table 1 of the NVLSP guide.  It was noted that Agent Orange
and its component dioxin could affect the blood vessels in
this particular pathophysiological manner.  The author
specifically concurred with Dr. S. F. B., opining that the
veteran's exposure to Agent Orange is most likely what led to
development of the avascular necrosis of the hips.   

What does this mean for our C-123 veterans? Many of us have hip and knee problems. For our vets who are Vietnam veterans and diagnosed with AVN, I'd suggest filing an application to have your condition recognized and service-connected. For non-Vietnam veterans who flew the dixon-contaminated Provider, it means one more illness for which we can thank Agent Orange and the Air Force failure to properly decontaminate the airplanes before ordering us to fly them. If you're already diagnosed with AVN as I was, I suggest that you amend your application for benefits to include AVN and support it with your physician's letter!

Note: you may see AVN described as osteonecrosis, aseptic necrosis, ischemic necrosis or bone infarction. Pretty much all the same. Besides Agent Orange, it is also associated with heavy smoking, heavy drinking, steroids, diving, and sickle cell. Victims experience increasing pain and decreasing range of motion, eventually to the point where even resting in the prone position is painful.

A Little Vacation - Blog will be off-line for a couple days

Wes

This is sort of a personal entry in our C-123 veterans blog...hope you don't mind the editorial privilege after 226 earlier posts.

We will be off-line for a couple days beginning Monday. I'm in for another round of surgery at Oregon Health Sciences University...great place, great docs, and a great cafeteria. The reason is a problem called Avascular Necrosis (AVN) which will force replacement of my hips, and perhaps my knees also. This will be my 12th surgery since the end of the Gulf War. And AVN is now associated with Agent Orange. Oh, the joy!

OSHU...first university to identify C-123 dioxin exposure!

And my AVN, like our Agent Orange exposure,  also has a VA connection. Last year, in significant pain, I sought care in my local VA emergency room. The ER x-rays showed AVN, and the next month I was seen by a VA orthopedic surgeon. He dismissed the AVN diagnosis made in the ER, according to the notes he entered, because I had no history of being on a specific medicine which causes about a third of AVN cases. Patients who have joint pain, and who have a history of using that medicine, are supposed to have AVN considered during their doctor's examination.

And if this doctor had read a few pages back in my VA medical records...which were right before him on the same computer he was entering his notes with, he'd have seen I had been on that medicine for two years...two years of treatment by the VA.

I didn't learn of his error until later this year at the VA when I was having a procedure guided by fluoroscopic imaging, and the doctor mentioned the AVN that he observed, and mentioned also that my hip was fractured.

Ten months had passed since the ER visit in the same VA facility...ten months of increasing discomfort, and ten months of progress of the AVN disease which might have been halted, or at least slowed, by medicine. Maybe even tomorrow's surgery prevented.

The VA couldn't get me reviewed for the necessary surgery for a couple months which would have meant waiting even more months until the surgery itself. So off to a civilian facility where I was seen and surgery arranged within two weeks by an outstanding professor of medicine. Tomorrow I'll wake up with a new steel hip and a tray of hospital jello for dinner...yuck. Four weeks of rehab - double yuck.

Comrades, we've had a miserable year struggling through this C-123 contamination issue trying to get the VA to care for our Agent Orange illnesses. We're not there yet although a tremendous amount of information has been collected to support our position, and we have also gained the support of outstanding scholars in this field, journalists, legislators and veterans organizations. We'll prevail. But the problem is that there will be fewer of us to prevail than when we began...because the VA continues to refuse recognition that our decade of flying the dioxin-contaminated C-123 exposed us to that dioxin. The VA says "contamination-yes, exposure-no."

Even though the VA sometimes misses the mark as seems to be the case with my AVN disease, the VA are the go-to guys for Agent Orange presumptive illnesses, and the VA is where veterans must go when they lack other insurance. So it is a problem when the VA pretends that we haven't been exposed to dioxin.

Speaking for myself, I wish the VA would spend more time and effort properly caring for me and the guys I flew with than in preventing C-123 aircrews from being eligible for VA care!

I want to shout out my sincere appreciation for my VA dental service, for my primary care provider, for my prostate cancer team, the ER, and the imaging services. I'm blessed with the freedom to bitch and moan about the VA and still turn to the VA for treatment by people who truly care about me.

I wish that all our C-123 maintenance personnel, aerial port guys and aircrew could get the VA care they deserve!

I wish that all our C-123 maintenance personnel, aerial port guys and aircrew would shout at their elected officials, demanding that the VA grant service connection to our Agent Orange veterans! We need people like Senator Patty Murray of Washington to be beating on the VA for us...as has her ranking member Richard Burr.