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      The following is on my About page, but some have been asking how this all happened. So here is my little story. Tbird US Navy 1983 – 1990 E-6 HadIt.com the website domain registered Jan 20, 1997 the domain is registered and paid for through Jan 21, 2023 at which time I plan to register it for another 15 years Lord willing and the creek don't rise. I guess the best place to start is Jan 1991; I had gotten out of the navy Dec 1990. At my separation seminar, there was a DAV rep Jim Milton he told us to bring our medical records in and he would look through them for us and let us know if we should file a claim with the VA. Well, bless his heart, he opened my medical file, reads the first insert, looks me straight in the eye, and says you will be 50% for the rest of your life and he would file the claim for me. 50% was for surgery I had in the service. True to his word he met with me and talked with me for a long time filled out my paper work and urged me to file for PTSD. 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Up to the pysch ward I went, blah, blah, blah, a few days later I was released with a promise of a call from the out patient program, which I would soon be entering. Blah, blah, blah, after many missed communications, and no call backs I was at the Day Hospital everyday M-F. And this brothers and sisters is where I began to learn and formulate my plan for HadIt.com. Veterans, veterans everywhere…I spent a year in the day hospital and about another year at a sheltered workshop before I got back on my feet. So I just talked to veterans everyday waiting for appointments, waiting for prescriptions, waiting for a vet rep and I started to learn the system. While in the navy I was data analyst and had to learn a 5 volume manual and just about anything you were suppose to do was in that manual. So I figured there must be a manual on how to do a VA claim or at the very least regulations. 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So taking my lesson from the squirrels earlier I started to gather, gather, gather…and learn HTML and work as a marketing systems analyst and work my claim. 1996/1997 major PTSD cork blows and unemployed. Working my claim, working the website. 20 Jan 1997 register HadIt.com domain name right after getting off the phone with the VA and saying I've had it with this. As fate would have it the old DAV board goes down just as mine opens up and folks start to wander in. So HadIt.com has two main components the website which supports the discussion board with links, articles, research resources etc. The website starts to grow, I can't tell you how many times I had to switch servers for space and features. I continue on a downward trend and in 1998 ended up back home in St Louis living in my sisters basement in therapy and working it, I swear I would have swung a dead chicken around my head at midnight naked if I thought it would have helped. The website continued to do great during this time, I just stayed in the basement bought new software, new books, and learned how to make things work and I continued to use this knowledge to make HadIt.com better. My 100% finally came through from the VA and I had a friend who is an advocate who helped me thru my SSDI claim, he was literally at my side thru the entire process and that came through for me. My therapist and sister continued to try and get me to leave the basement, but to no avail. At some point in 1998 or 1999 I put a counter on the website and was shocked to discover how many visitors we were getting. Time goes by my sister gets married and I move from the basement to the upstairs, there is much celebration that Aunt T is living in the light again. More time goes by and I settle into my life in St Louis and spend more time on the site trying new things, finding more information. 2003 I buy my own home VA loan. For years now I have just considered HadIt.com my job and I get up every morning go to the office and work for several hours, take an afternoon break and see where the rest of day takes me. I have a place in the office to use the computer and a comfortable to place to read journals and articles and take notes. Blah, blah, blah so that is my story and HadIt.com's intertwined.
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      VA Training and Fast Letter Forum Index The following is the index with links to the various Training and Fast Letters plus a few miscellaneous. These letters are not necessarily in the original formatting. I have tried to present them in an easy-to-read form instead of some forms as originally presented. Some of the paragraphs were WAAAAYYY too long. lol - HadIt.com Member fanaticbooks Something to be aware.... Some of these letters may be rescinded, outdated, or otherwise no longer viable. I have still included them because sometimes they provide additional insight or just plain more information than the newest version. Use them wisely. The oldest letters will display at the bottom with the latest letters displayed at the top, all in sequential numbers. Coding of the letters... FL = Fast Letter TL = Training Letter First two numbers = last two digits of year of origin Training Letter http://www.hadit.com/forums/index.php?/topic/40694-va-tl-00-07/ http://www.hadit.com/forums/index.php?/topic/40693-va-tl-00-06/ Fast Letter Number Title http://www.hadit.com/forums/index.php?/topic/44262-va-fl-11-15/ http://www.hadit.com/forums/index.php?/topic/44260-va-fl-11-13/ http://www.hadit.com/forums/index.php?/topic/44261-va-fl-11-11/ http://www.hadit.com/forums/index.php?/topic/44310-va-fl-11-09/ http://www.hadit.com/forums/index.php?/topic/42151-va-fl-11-03/ http://www.hadit.com/forums/index.php?/topic/40957-va-fl-10-49/ http://www.hadit.com/forums/index.php?/topic/40958-va-fl-10-46/ http://www.hadit.com/forums/index.php?/topic/40959-va-fl-10-45/ http://www.hadit.com/forums/index.php?/topic/40960-va-fl-10-42/ http://www.hadit.com/forums/index.php?/topic/40961-va-fl-10-39/ http://www.hadit.com/forums/index.php?/topic/40962-va-fl-10-35/ 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  • 0

Sleep Apnea

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Just finished having a sleep study the other night. Halfway through, I was hooked up on the CPAC machine. I was asked afterwards if I thought my sleep was better.

The official results won't be known for another week. My guess is based on this test and the fact that I had respiratory failure due to low oxygen level I will be recommended to go on the CPAC.

I am already service connected for hypertension and cardiomegaly. Would I file this new claim requesting secondary to either one as sleep apnea?

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85 answers to this question

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If you can get a nexus statement from a Dr. stating that the Sleep apnea is caused by either of those conditions sure.

In actuality (with out the specifics from your records), it is more likely that your hypertesion and cardiomegaly might have been caused or increased due to sleep apnea.

Many people will have sleep apnea for years even decades before diagnosis.

I currently have a claim in for Sleep apnea that was diagnosed 11 years after service. My pulmonologist's nexus statement says more likely than not and goes on to point out the 4-5 medical facts/indicators from my smr's that back up his conclusion. Hypertension and enlargement of the heart are two of them. In service they stated my hypertension was essential (no identifiable reason).

When I was placed on CPAP they said - you won't want to wear this but you need to - I slept like the dead the first two days and was amazed as how much better I felt. Not waking up on the wrong side of the road is a big plus also. Sleep hasn't been so kind to me lately though due to the pain issues with my back/legs.

A CPAP can be a life saver and improve you quality of life big time.

Best regards,

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Posted · Report post

Thats good information-hopefully they approve this!

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Posted · Report post

A CPAP use is only half the battle in obtaining SC for OSA. At least one of the docs need to supply a nexus statement linking military service to your diagnosis of OSA. My experience has been that docs hand out sleep apnea nexus about like a mother bear lets others handle her cubs...you can ask, but dont count on it. Try a Vet friendly doc.

Do persue the use of the CPAP, if needed, for your health reasons whether or not you get SC for it. The CPAP has a smart card in it that records whether you are using it nightly or not. I use a CPAP, and am NOT SC for it, have been using it for 3 years. I think my number was 67apnea events, meaning I stopped breathing 67 times per hour (or per night, I forget which).

If you are prescribed a CPAP, I whole heartedly recommend you use it, but you need to understand it will likely take some getting used to. You may have to switch masks, pressure, etc. The doc sets the pressure at a certain number of pounds. Mine is 9 pounds air pressure. He determined that number at the sleep study, decreasing the pressure on the cpap to the lowest number that eliminates apnea events.

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Posted · Report post

Thats is some very good information. How would you access the smart card to see if you stopped breathing. Perhaps there s an instruction for that.

As far as getting service connected for sleep apnea, a few years back when i got my c-file, one of the service officers had wrote that veteran didn't mention or make it known that he also wanted to file for fatigue. We'll, I am always tired because I can't get a good night sleep. I understand the cpac machine helps you sleep much better.

This is all being done through an outside MD referred through by base doctor for tricare prime. So when this all done, I will schedule an appointment for the VA doctor and give them all the medical reports from the hospital-sleep study and pulmonary doctor. Once that has all been documented(I will getaq copy of this visit notes),then I will carefully put together my next claim. I will let this doctor know that I am a Veteran and if he could write a nexus letter so I can get the VA to give me the machine.

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Posted · Report post

Cool Breeze:

I had a sleep study done by Kaiser and they prescribed a CPAP machine, the only problem was that my policy didn't cover it so if I wanted one I needed to pay for it out of my own pocket. I mentioned to my VA PCP that I thought that I might have sleep apnea and he sent me top the sleep clinic, they did a sleep study and two weeks later gave me a CPAP machine, so far I haven't seen a bill and they gave me the machine last August. So I guess what I'm trying to say is that the VA will probably make you take another sleep study.

On sc there needs to be something in your SMR about snoring or being tired. Back in the 60s and 70s nobody knew about sleep apnea and generally if you went to sick call about being tired and snoring they told you to cut back on the partying and to sleep on your side.

Rick

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Posted · Report post

My tricare covers 80%. My share would be 20% which isn't bad at all. If these results come back indicating in need the CPC(expecting due to result test) then I will ask for it in good time. Sometimes they provide good equipment. When they informed me my blood pressure was high and how often do I check I informed them I never do cause I can't afford the blood pressure kit. The wrote out an authorization and I picked it up on the spot.

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If would be nice if we could all get our apnea SC'ed but that is not the main thing. The main thing is to get it treated. I am having a pretty hard time with mine. With my Cpap I wake up pretty frequently. I get very dry even with humidifier. It seems when I get a good seal it makes my face very sore the next day. When I get it loose enough to not pinch I have a lot of leakage and I still wake up about 5-7 times a night. I am often very sleepy during the day. I want this to work so I will continue to see the doctor. I see both private and VA doctor. When I wear the mask I don't snore my wife tells me. I may have had apnea for a long time since I have had sleep problems for years and I did have sleep problems in the army. There is a particular instance where I went sort of wild from lack of sleep one time in the army and it is documented. I got no treatment, of course.

John

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Posted · Report post

It kind of scares a bit from reading from the posts here. Its supposed to help, however it has its drawbacks. Lots of folks(even my relatives) get diagnosed and refuse to use the machine. I guess you will just stop breathing some night and it will be all over with. And just to get it adjusted right, is a work in progress, I had it just quickly and correctly for my sleep study, however they are the experts. Hopefully I will be given some training first.

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Posted · Report post

The important thing is to get your sleep apnea treated and that means getting and using the CPAP machine, not using the machine can lead to other things such heart failure or death, my buddy's niece died because of untreated sleep apnea.

Getting mask adjust just right is a pain,if it's too loose you have leakages and the machine can't do it's job, too tight and you end up red marks on your face, even when they've adjusted the mask for you when they gave it to you may find that when you get home and hooked up that you need to make adjustment. Another thing that been recommended to me by a number of people is that you wash your face before going to bed, apparently the grease and oils on our skin will affect the fit. John if I use a nose mask I don't have a problem with dry mouth but I hate having to use the chain strap but if I use a nose and mouth mask I do wake up with dry mouth.. With my machine I've gone from waking just about every hour to waking up once or twice during the night although there are times when I wake up more often, when that happens I find myslef having to take a nap during the day.

Rick

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Posted · Report post

I also have to see a pulmonary specialist. Not sure if this for something else, or if this goes with being diagnosed with sleep apnea. Perhaps I had multiple new conditions from my latest stay in icu.

It will be a week or so before they have the final results. Normally they don't hook you up to a CPAC machine during a sleep study unless the technican that was observing you noticed something unordinary.

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Getting hooked up to a CPAP during the sleep study usually depends on what kind of study it is. My sleep study for the VA was a Holter monitor that I wore to bed one night then sent back to the VA, a week later they called and made an appointment to pick up a CPAP machine, that was in August. Next month I'm supposed to have an appointment with the sleep doctor who I believe is a pulmonary specialist. Now sometimes you do a sleep over sleep study where you spend the night at the hospital or sleep clinic being monitored, I understand that if that is the type of study you get they may wake you up during the night and put you on a CPAP if you're having sleep apnea events.

Rick

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When I had my sleep study , it was conducted at Randolph AFB. The procedure was to connect me to a bunch of wires using some red gel in my hair and stickers on the rest of my body. Then they monitored my sleep, not only with the wires connected to my body but with a camera. I was told that I woke up due to apnea 56 times.

I had to return to the clinic three weeks later, and this time I was fitted with a mask and monitored using cpap. I lasted 4 maybe 5 hours.. I did not sleep at all... it took all my will power not to rip the mask from my face.. which in the end I did. Not only did I rip the mask from my face... I went home at 3: AM.

A month later the va issued me a cpap machine. I tried 4 or 5 different mask each with the same result, as long as I had the mask on I did not sleep at all, I could not even fall asleep. I finally determined waking up durning the night was better than no sleep at all. Of course another problem with me was when I took the mask off, I was not getting my oxygen either which I need 24/7....

The doctor at Randolph insist that my apnea is not secondary to my asthma/copd.. but she never took the time to look at any medical records, or explain to me what it could not be secondary. This was two years ago.

I am just now considering an IMO from a private sleep clinic.......

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Mmmmmm.....something does not sound right in VA logic. If you cannot sleep at all with the Cpap I wonder if you have tried sleeping pills with it? The thing is with the copd and other problems there is a lot of stress on your heart and lungs. I would find the best doctor in your city who has a connection to a sleep lab and do the whole thing again. The waking up and snoring from apnea is bad and a pain,but the strain on your heart is the real danger since you already have copd. You need to see if the cpap is even working for you and the only way is for you to fall asleep with it on for a few hours. I am wearing my cpap but I am very sleeping when I wake up in the morning and I wake up many times at night.

John

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I now go through tricare to get all my referrals. Then I call VA and tell them I need an appointment because I know they have a different procedure. They want to use there own doctors to diagnose you . Then you can ask for any equipment, in this case the CPAC machine. You can get treated much quicker by going through your own insurance, if that is possible.

It can take 3-6 months to get a specility doctor from the VA. Normally I can get an referal and see actual MD within 3-4 weeks. In my case, I had the sleep study within 2 days of having the doctor sending the request in.

No need to die while waiting for the VA to get you an appointment. . Today's paper in my home town listed a Vet who recently died at the VA during surgery. The same almost happened to me at a private hospital as the VA never provided the healthcare that would have found I had other issues. I had told them repeately I had problems sleeping for years. I was quickly referred to this sleep study from my private insurance. Shame on the V A once again!

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With my CPAP I wake up once or twice a night without it I'm up every hour. When Kaiser did the sleep study they told me that I averaged 36 events per hour.

My first mask was a nose mask and I rarely had a problem with it but there were a few nights that I couldn't get my breathe and ripped the mask off during the night, now I have a nose mouth mask and so far it's working great.

Teac;

I think that there's a way for you to use oxygen with the CPAP but I'm not sure how it gets hooked up.

Cool Breeze;

You're right that it take a long time to see a specialist, I waited for three month for my appointment with the sleep clinic, I have Kaiser so I get most of my medical treatment thru them but with them I would have had to pay almost $900.00 for the CPAP machine which the VA gave me for free, the VA also gives me all of my CPAP supplies for free rather than me having to spend $200 every six months for a mask.

Rick

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Mmmmmm.....something does not sound right in VA logic. If you cannot sleep at all with the Cpap I wonder if you have tried sleeping pills with it? The thing is with the copd and other problems there is a lot of stress on your heart and lungs. I would find the best doctor in your city who has a connection to a sleep lab and do the whole thing again. The waking up and snoring from apnea is bad and a pain,but the strain on your heart is the real danger since you already have copd. You need to see if the cpap is even working for you and the only way is for you to fall asleep with it on for a few hours. I am wearing my cpap but I am very sleeping when I wake up in the morning and I wake up many times at night.

John

Yes.. I have considered another sleep apnea test.. however just the though of going through it makes me sick... I know I need to do something because I usually sleep in my recliner 5-6 hours a day because I am not sleeping at night. I am also trying to find a place that will review my medical records and determine if my asthma/copd and allergic rhinitis caused or made teh apnea worse... Of course I am over weight so that is another problem, but I've only been overweight for about 7 yeas and I had this problem back when I was in service. Of course back in 1986 when I retired no one knew anyting about sleep apnea, of if they did, it was never mentioned to me....Recently my doctor told me if I could lose weight my breathing, back, and knees would improve.. but that is eaiser said than done. He also told me my weight is my biggest medical problem....so who knows.....

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If would be nice if we could all get our apnea SC'ed but that is not the main thing. The main thing is to get it treated. I am having a pretty hard time with mine. With my Cpap I wake up pretty frequently. I get very dry even with humidifier. It seems when I get a good seal it makes my face very sore the next day. When I get it loose enough to not pinch I have a lot of leakage and I still wake up about 5-7 times a night. I am often very sleepy during the day. I want this to work so I will continue to see the doctor. I see both private and VA doctor. When I wear the mask I don't snore my wife tells me. I may have had apnea for a long time since I have had sleep problems for years and I did have sleep problems in the army. There is a particular instance where I went sort of wild from lack of sleep one time in the army and it is documented. I got no treatment, of course.

John

Are you on a full face mask or just the nose? I had terrible problems with TMJ and waking up with my mouth open and the air rushing out (so dry I couldnt swallow) Full Face solved those.

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Sorry about my post on full face versus just nose, hadn't read all the way through the updates on the thread at that point.

Another thing that is adjustable on the machines is somehting called "ramp" this setting uses a lower pressure setting at first and then increases it up to theraputic level. Last I knew my setting was 12.9 and at one time I think it was 14. I have never liked ramp up settings because I always feel like im not getting enough air so I shut it off and we go straight to full pressure. When I started using VA healthcare they issued me a machine and that machine also would dump the pressure on exhale. After ten years of full pressure all the time, it just was so strange i shut off that function also. That function also caused the noise of the machine to oscilate with my breathing and it drove the wife nuts. In the rare instance that I am not sleeping at home my wife has to turn on a small fan to make up for thier being no noise from the CPAP.

Reading through the BVA decisions on Apnea is interesting because they will point out no "in service" evidence of apnea, but in the rating schedule it clearly indicates someone can have apnea and be asymptomatic.

If denied, because I wasn't complaining I will argue that I had the medical indicators and the rating schedule clearly shows that the Veterans Administration anticipated/recognized that someone could have sleep apnea and not exhibit outward symptoms of it.

Best regards,

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Myself and many others are very greatful for those sharing there input on this subject matter. It definitely has given me some things to think about. And for others getting ready for a sleep study, or recommended for the CPAC machine they can follow along here for a few ideas on what to expect.

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71M10

I am on the full face mask but I still get dry. I have a humidifier built into the cpap and I have a separate humidifier that goes full blast all night and yet I still get dry. I do find that If I get the mask pretty loose I do better. If it is real tight it hurts my face and drys me out so bad I can even speak. Many people I talk to throw they mask away because of problems but that is not the answer. I have TMJ also. The snoring is bad but I worry about my heart.

John

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John;

From what I was told at the VA sleep clinic the dry mouth is due to you sleeping with your mouth open, if I use the nose mask and chin strap my mouth doesn't get dry nut when I sleep with the nose and mouth mask my mouth does get dry. Like you I've played with the humidifer that's attached to the CPAP and it makes no difference. Untreated sleep apnea will cause heart damage and death.

Rick

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Comp Tech

I have deviated septum and can't breath through my nose very well.

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John;

I'm not sure if it'll help with the dryness but they do make a total face mask which covers the nose, mouth and eyes, kind of like a gas mask. One of the things that I've found is the fit of my mask will depend on my position, lying on my left side the mask fits fine but when I turn onto my right side I get leaks, I don't know about when I'm on my back because I can't sleep lying flat on my back. In the back of my mind there's a memory of someone telling me something about a true fit mask that you don't need to adjust but I'm not sure how that works. I hope that you find something that works for you.

Rick

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We could get rich if we could start a company that makes custom fitted face masks.

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John

We wouldn't even need to make custom mask, I don't know if you've priced makes but the cheapest ones are about a hundred dollars and you're supposed to replace them every six months. If I had had to buy the full face mask that the VA gave me it would have cost me $195.

I did an experiement last night, I set my humidifer to its highest level and it made no difference in the dryness of my mouth. Yow know John I can live with the dry mouth as long as the machine does it's job and I get a good night's sleep. It's a hell of a thing when a sixty-five-year-old man has to take a nap two hours after he wakes up in the morning.

Have a good day,

Rick

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