Image Shot 2/12/2016 before I was spending 21-23 hours a day in bed. I can no longer sit upright for long due to the problem I have with my posture/spine.
My Story is truthful to the best of my recollection. I realize taking the time span and my diminished cognitive abilities into consideration, a mistake is possible.
I urge any individual I mention
in My Story to feel free to comment. You can do so on the Comment page.
I will post any comment you wish to make;
Dr. Dung Le, Nicole Prieto, Melinda C Boudah, Sandra Koeing, Becky Grindle, Gwendolyn Flowers/Marcia Hennesy (Non-VA Care), Dr. Shorter, Nancy Reissener, Acting Director, Thomas Wisnieski, Director, Dr. Mount, Dr. Fernandez, Dr. Paisoody, Nurse Hope (Psych Ward/5 Something), Dr. Stone, Dr. Surabhi and Dr. Trigg of the MRVAMC.
Sherry Carter, Dr. O’Malley, and Dr. Griffith of Hampton Oaks ENT. Stephen Baldo of Brooks Home Health Care. Dave Hill, Office of Congressman Ted Yoho.
My Medical Records from 2012 on are available to review by anyone that disputes any claim I make on this website.
Carl V Holgate
Click On Images To Enlarge
Shortly after arriving in Gainesville I began to feel terrible again. When I met with my new Primary Care Provider (Primary), Dr. Le, I told her my story. I was impressed: she set me up for various outside clinics to address the symptoms I shared. All tests came back negative.
While it wasn’t as bad as in Prescott, I knew something was wrong. I eventually chalked it up to Chronic Fatigue Syndrome; Dr. Le was happy to accept my conclusion. I committed myself to living with it.
started getting worse in May of 2014, I emailed Dr. Le explaining what was
going on with me physically and demanded something be done. She set me an appointment with
Neurology and the Gait & Balance Clinic. I met with both on the same day in
the Gait & Balance Clinic.
Please Note: I have always been in the habit of deleting old emails, and I had done so until after the email mentioned above when I had a gut feeling I should save all correspondence between myself and the MRVAMC. They can be found in "My Medical Records.
The Neurology lady did her thing first, then left and told me I would be informed of her findings, they never did get back with me. Nicole Prieto, my physical therapist determined my problem was ‘Rocks in my Head.' That is another term for Benign Paroxysmal Positional Vertigo (BPPV) which could be corrected by employing the Sermont Maneuver which I began doing twice a day as she directed. In about three weeks I knew when the “Rocks” went back where they belonged. There was only one problem; I was still feeling terrible, and I still experienced balance problems, although not as bad as before.
Please Note: The Sermont Maneuver comes into play before my last visit to the MRVAMC on 9-10-15. I made attempts to determine if the maneuver itself could be adding to the problem I was experiencing in my left ear. The BPPV is in my right ear.
The key here is Vestibular Disorders,
of which there are so many it is scary. What’s worse, it takes a Vestibular
Disorder Specialist (otolaryngologist) to diagnose, and then prescribe
treatment/surgery/therapy based on various tests and an MRI. I learned this when Nicole suggested I go
onto the Vestibular Disorder Association (VEDA) website to gain an
understanding of Vestibular Disorders. From the VEDA website I ordered the book
“Finding Balance” by Sue Hickey. The book chronicles her ten year struggle with Vestibular Disorders.
I did another test, and it was
determined by Nicole I was also suffering from Bilateral Vestibular
Hypofunction (BVH). I was given a set of
balance exercises to do to improve the condition. I did the exercises twice a
day religiously until eventually quitting for fear of falling.
Once it became evident from my experiences at Gait & Balance BVH was not the only Vestibular Disorder I was dealing with, I began reading Finding Balance. I had only skimmed through it before. This time, I read every word and started marking pages that related to the symptoms I was experiencing.
Numerous Vestibular Disorders exhibit the same symptoms, thus the need for a Vestibular Disorder Specialist (otolaryngologist) to diagnose and prescribe treatment. I learned Physical Therapists are not qualified to give accurate Vestibular Disorder diagnoses. One would think when I didn’t improve with the balance exercises Nicole prescribed; she would have put in a consult to ENT.
I believe Nicole is a competent Physical Therapist and has the veteran’s best interest at heart. I tend to believe she didn’t believe what I was telling her was the truth. This falls right in line with all those at the MRVAMC who believe, in my opinion, I’m either a liar or delusional.
I related to the symptoms of Perilymph Fistulas, had I found the source of my problems? I realized it was a long shot, but at least I had something to go on. It’s hard when you know your health is in rapid decline yet have no idea the reason! I adopted Perilymph Fistula until proven otherwise, fully aware it could well be something else.
My annual was coming up with Dr. Le, 7-28-15. I was determined to be seen by ENT in hopes there was an otolaryngologist on staff.
I brought Finding Balance with me; I was hoping I could convince Dr. Le I needed to be seen by ENT. She did her thing which consists of 70% making entries into her computer and 30% listening to me on average. In her defense, it's evident she has a tremendous workload of one veteran after another and, in my opinion; she was tiring of my constant requests for help. I felt long before that day I had become nothing more than an annoyance to her.
I shared a passage in Finding Balance with her that she entered it into her Progress Notes. Not sure my attempts to educate her in regards to Vestibular Disorders was worth the effort, I went home in hopes I would make it to ENT and find the help I needed.
A few days after my last visit I began experiencing new symptom’s and for the first time I felt something going on in my left ear. The following email exchange ensued.
Please Note: After reading Finding Balance and the diagnosis from Gait & Balance
I Believed What I Was Dealing With Was Vestibular In Nature.
In the last image above you will see a notation I made (see arrow), I was beginning to believe I needed to find an outside specialist (otolaryngologist), but I wasn’t willing to give up on the MRVAMC just yet. REMEMBER… The VA had always been there for me, and it wasn’t easy to accept this was no longer the case! --Click On Image To Enlarge--
On 8-12-15 I sent the following message to my Primary:
Sent: 08/12/2015 02:33 AM
From: HOLGATE, CARL
To: ** Le,D_GNV_PACT 11
Subject: General Inquiry
As mentioned previously when explaining my various symptoms, I experience a pressure in my head. That pressure has intensified in my left ear. In addition, I am experiencing bouts of what I can only describe as a cross between mild pain and intense itching (so much so, it is hard to keep my fingers out of my left ear when this happens).
Also, I have had periods of ringing in my left ear that lasts for a minute or two. I thought something was going on with my left ear when I asked Max if flushing could be a problem on my last visit. I have but one question... Does the Gainesville VA have a Specialist in Vestibular Disorders. That's all I want to know. If you can't answer this question please direct me to the person that can.
Please Note: I will keep all appointments you schedule.
"If you listen carefully to the patient they will tell you the diagnosis."
Carl V Holgate 5921
On 8-20-15 I received the following reply:
Sent: 08/20/2015 12:24 AM
From: LE, DUNG
To: HOLGATE, CARL
Subject: General Inquiry
I WILL TRY TO ASK ENT FOR YOU. DR. LE
/es/ DUNG N LE
M.D., PRIMARY CARE
Signed: 08/20/2015 00:25
On 8-21-15 I sent the following message;
Sent: 08/21/2015 12:21 AM
From: HOLGATE, CARL
To: ** Le,D_GNV_PACT 11
Subject: General Inquiry
I appreciate your effort... But it will no be longer necessary. After a near fall in the bathroom I began the Sermont Maneuver again an hour ago. If it causes additional damage to my left ear I'll have to deal with that later.
If I do not get the crystals in my right ear back where they belong by next Tuesday I will have a real problem making my appointment with audiology on 8-26, not to mention the hell I'm going through. During our last appointment I was dealing only with BVVH and whatever is happening in my left ear.... Not All Three At The Same Time!
Please Note: I did receive another email that I believe was sent to Dr. Le from ENT
that said all doctors in ENT had some familiarity with Vestibular Disorders.
The Sermont Maneuver is performed as the image portrays. It's repeated three times twice a day. During my second attempt of the day, I felt a sharp pain in my left ear; I've not done the Sermont Maneuver since.
That night was the beginning of episodes of nausea that were so bad it was debilitating. I began experiencing dry heaves and the return of headaches.
I emailed Dr. Le, an appointment was set for 9-10-2015. I had to take a cab and returned home the same way. I could barely walk even with my balance staff. I couldn’t think I was feeling so sick and disoriented the day of the appointment!
I am still in shock over what transpired once I arrived at the VA. I have a hard time believing any medical facility in the United States would have allowed me to leave in the condition I was in, not to mention my dangerously high blood pressure readings.
Please Note: My high blood pressure (BP) has baffled the VA since this all began back in 2010, as it had me until I figured it out. I have numerous recorded accounts of dangerously high BP at both the Prescott VA and the Gainesville VA. Now for the interesting part: In each instance when I left the house my BP was within the safe range.
My Theory: When I am in the prone position I require every ounce of energy and mental focus I have to remain in an upright position. Factor in walking, which requires even more energy/focus, not to mention the stress factor involved, a rapid increase in blood pressure results. Dr' Le seemed to accept my theory.
The following account is a pivotal point in My Story and
explains why I
made the decision any further attempts to get the help I needed
the MRVAMC was both futile and was putting my life/limb in danger.
I knew my BP was high when waiting to be seen by a nurse, so I did deep breathing exercises and meditation until I was called into the nurse’s office. I was seen by Linda F Showell within fifteen minutes of checking in. My BP alarmed Linda, 207/97. I informed Linda I needed a wheelchair after her job was done, she left to find me one. As I sat there, her small office began closing in on me and I felt I had to get out and return to the waiting area which I did using my balance staff while wall hugging my way back. Please Note: My BP was within safe limits when I left my home for the appointment. Linda returned to the waiting area and informed me there were no wheelchairs available, but she ensured me she would get someone to assist me to Dr. Le’s office when called. I declined; I should have taken her up on the offer.
Shortly thereafter, Dr. Le called me to her office; she noted in her Progress Notes dated 9-10-15 that I had difficulty walking. She did her thing and determined my problem was Swimmers Ear. I couldn’t believe that was her diagnosis. I had Swimmers Ear when I was young and knew I didn’t have it again, although the symptoms I was experiencing were similar, I did not have Swimmers Ear! This was the second wrong diagnosis in a matter of a few months.
Dr. Le prescribed antibiotics and Swimmers Ear drops. She looked surprised when I requested they be mailed. I did this for two reasons; I was in no condition to make it to the pharmacy and wait, and I knew I didn’t need antibiotics. Both are still in the bag they were mailed in unopened. I only take antibiotics when necessary. For a doctor to prescribe antibiotics when she admitted to me, she saw no sign of infection is, in my opinion, Medical Malpractice.
When Dr. Le took my BP, it was higher than when the nurse took it. All I remember her saying was 225 over 90 something. I thought she said 195, but I now know that’s not correct. Once I heard 225, I became very concerned for I didn't recall it ever being that high. Dr. Le had to realize it would only go higher once I left her office.
Please Note: The MRVAMC is the only VA I’ve ever been to that allowed me to leave with a dangerously high BP.
Once again I told Dr. Le I needed to be seen by ENT. She again informed me I would have to see audiology and neurology first then they would decide if I needed to be seen by ENT. Once she gave the wrong diagnosis of Swimmers Ear it meant she was done with the matter, leaving me no option but to accept her assessment.
Please Note: The appointment I had with audiology was to test my hearing, it was not the testing required to determine whether or not my problems were vestibular in nature. I had an appointment with audiology before my visit to Dr. Le, but audiology canceled it and rescheduled for the week following my visit to Dr. Le which meant my audiology appointment and my neurology appointment were two days apart. In Short: It had nothing to do with the cause of my problems; I had gone through the very same testing while at the Southern Oregon Rehabilitation Center and Clinics in White City, OR a year earlier. I was provided hearing aids. I called audiology before my first appointment and was informed the testing scheduled was for hearing, not vestibular.
Before I left Dr. Le’s office I told her if audiology and neurology determined I didn’t need to be seen by ENT I would seek help outside the VA regardless the cost to me. When I left, I had every intention of making the upcoming appointments the following week. By the time I made it the two hundred feet or so to the Valet Parking area I could feel my heart pounding as my BP rose. Once there I sat down and called the same cab company I used to get me there. I informed the dispatcher I would be in the Valet Parking area.
Fifteen minutes or so went by when I saw a cab go past the Valet Parking entrance to the lower level entrance; I assumed it was my cab going to the wrong door. Instead of calling the cab company back I decided to take the steps to the lower level and catch the cab. It was not the right decision, but I was feeling so sick all I wanted to do was get home.
I had put my phone in my shirt pocket instead of my pants pocket to make it easier to retrieve when needed. Standing at the top of the staircase I shifted my balance staff to my left hand while I grabbed the handrail firmly with my right, I had only descended a couple of steps when my phone rang; it startled me.
Realizing I was in a precarious situation I jammed the staff hard against the left side of the staircase then wedged my right arm between the handrail and the wall on the right of the staircase. I managed to retrieve my phone with my left hand after tucking the staff securely under my left arm. I reasoned if I were to go down the worst injury I’d receive would be a broken right arm/dislocated shoulder and I would be able to hang there until I could summon help.
The only reason I answered the phone was because I thought it was the cab driver wanting to know where I was. The call was from a friend and former employer in Prescott, AZ, Kevin Powell. I informed Kevin I would call him back when I got home, which I did. Once my phone was returned to my shirt pocket, a gentleman quickly passed me on the left and turned to face me. He offered assistance, I declined.
My awareness of those around me, especially anyone behind me, was lowered due to the situation. Had the gentleman grabbed me from behind in an attempt to help before the wedging of my right arm I would have reacted to a perceived threat from behind and most surely would have taken a fall down the stairs. I believe the gentleman knew this.
I regained my composure and continued my descent then sat on the nearest bench available once I reached the bottom. There were no cabs in sight, I reasoned either the cab I saw wasn’t for me, or I took too long to get there, and it left.
Again I called the cab company and was informed the cab I saw wasn’t for me after all. I told the dispatcher my pick-up location had changed. As I sat waiting for the cab, I made the decision to risk returning the next week for my audiology and neurology appointments was insane. Please Note: Dr. Le had informed me twice the only way I was going to be seen by ENT was if audiology and neurology felt I needed to be seen by them.
The image to the left is what I refer to as balance staffs; they are telescoping Mono-Pods/Hiking Staffs used for photography. The broken one is the one I used on the day in question. When I entered the cab and went to close it I discovered the aluminum clamps had cracked, it fell apart at home when I opened it. I believe the force of jamming it so hard against the concrete was more than it was designed to withstand.
Should anyone question the above account;
Phone records are available.
VERY IMPORTANT… All the
decisions I made from that point on were based on repeated attempts to get help
from the MRVAMC and my belief from past experiences that I had reached a dead
end. I WAS SCARED for I knew whatever was going on was serious and no one at the MRVAMC was
listening to me!
The next segment of MY Story will chronicle my experiences of “Going off Reservation” without the permission of the MRVAMC and how they managed to sabotage my efforts forcing me back “On Reservation.” It will detail how the MRVAMC managed to influence the Specialist I trusted to help me, Dr. Mathew O’Malley of Hampton Oaks ENT, in their efforts to deny me the medical care I so desperately need.
3-29-16 Assessment by Dr. Mathew O’Malley Hampton Oaks ENT
I don’t think his (Carl V Holgate) balance problem is an ear problem. My suspicion is that his balance is either Chronic Suggestive Dizziness and related to his Mental Health Concerns, or it could be a central process perhaps related to his uncontrolled hypertension.
-Click On Images To Enlarge-
Before I bought the inflatable bed and before the escalation of my “Mysterious Illness” I started my day by cranking up Chuck Berry then I began a forty-five minute routine of fast walking, shadow boxing, and dancing to the music. Before my aerobic workout, I strapped two ten pound weights to my ankles and two five pound weights to my wrists. What a way to get the blood flowing and kick start the metabolic energy system!
When I moved to Gainesville, I bought a double wide mobile home and went to work remodeling it. I furnished the area sparingly because I wanted an open area free of clutter. I accomplished my goal. An added benefit, I had a mini indoor track, the great room through one kitchen entrance and out the other back to the great room. I wore a Garmin pedometer, during a forty-five-minute workout I walked on the average of 2 ½ to 3 miles.
My next routine of the day was to prepare breakfast; it’s the same now as it was then. I blend a combination of aloe juice, Braggs organic apple cider vinegar with Mother, chia seeds, hemp protein powder, organic ground cumin, cinnamon, ginger, super green, beet, and berry powder. I top it off with a little organic blue agave and Alcohol-Free Liquid Extract, Cat's Claw (Uncaria Sinensis). It’s best to drink it quickly; it’s not a beverage you want to sip on!
After breakfast, I took a fifteen to twenty-mile bike ride. I was averaging one hundred to one hundred and fifty miles a week. On Sundays, I made a day of it, thirty-five to fifty-five-mile rides. I was getting in shape for extended trips, one to three weeks, across Northern Florida. My goal was to combine my excursions with my photography. I wanted to write an Illustrated Travel Book.
I have managed to keep my demons (PTSD) at bay by staying active and through creative endeavors since I stopped trying to drown them in alcohol and drugs. Not only did it keep my body in shape, but it also helped keep my mind right.
I Ask You… Does This Sound Like The Routine Of A Depressed Individual?
Aerobics, stretching exercises, proper nutrition, and bicycling was but a portion of my fitness program. Three times a week I did strength training (Total Gym/Dumb Bells), not so much as to build body mass, but to tone and work all my muscle groups. I used my Teeter Board (Incline Therapy) twice a day to help keep my spine aligned, build core strength, increase flexibility, and reduce stress.
My Equipment Has Been Gathering Dust For Over A Year Now!
In addition to the above, I landscaped my yard, cared for my organic vegetable garden (in Florida you can grow year round), and maintained my lawn with passion. I live in a mobile home park. On more than one occasion I was complimented by the owners who appreciated the improvements to the park.
Please Note: Had I not been in the physical condition I was in before the last onslaught of my "Mysterious Illness" I wouldn’t have been able to deal with it as I have.
As mentioned previously, activity is how I managed to keep my demons at bay after I sobered up but as my condition worsened I had to give up one avenue of exercise after another to where I’m at the point of no exercise! Not good for my Advanced White Matter Disease, or my Blood Pressure.
I have added this information to My Story for one reason. The MRVAMC claims I'm depressed, and that's the cause of my physical problems. Later in My Story,
I will provide evidence to substantiate this assertion.
I took two classes at Santa Fe Community College, English 101 and Digital Photography. My highest level of formal education is the 10th grade; I got my GED while in the Navy.
I had to quit the English class because I was having difficulty retaining the information and homework was a chore. Never had I experienced the inability to learn when I wanted to, I shrugged it off and continued with the photography class. Little did I know
my dreams would soon become nothing but a memory!
I Submitted The Images Below For My Final Grade
I Explain The Above To Drive Home The Point I Had Reached A New Plateau In My Life
My time spent at the Southern Oregon Rehabilitation Center and Clinics
before moving to Gainesville not only gave me a New Outlook On Life, but it had
also provided me a New Set Of Tools to deal with my demons (PTSD).
For The First Time In A Long Time... I looked forward to the future!
Depression Didn’t Set In Until My Last Visit To The MRVAMC
Descent Into Darkness
Depression was not a stranger. Until our reunion in Prescott, AZ when all this began, the depression I experienced had been the result of my actions, to be more specific, my addictions. Example: Loss of family, loss of property, loss of jobs, loss of self-respect, etc.
Only once in my life had I ventured to the depths I was now descending. In 1985 I attempted suicide. My desire to put an end to my agony was prevented by a county sheriff, in the middle of nowhere in the state of Tennessee, minutes before it would have been too late. I was told by the sheriff the next day it was Divine Intervention. When he explained, I believed him.
Please Note: My belief God had intervened on my behalf comes
into play as I tell this segment of My Story.
Once I made it home from my appointment, I medicated, months earlier I had smoked a joint in order to see if it offered relief from my discomfort. How I ever became a Chronic Alcoholic considering the horrendous hangovers I experienced defies logic. Only one of three things worked; suffer thru it, get drunk again (which I did often), or smoke pot to ease the pain until time did its thing.
There was no denial on my part; I relapsed when I took the first hit. I wasn’t proud of the fact, but it was what it was. I state this now because it plays a significant role in the way I dealt with what lay ahead.
It’s important to note I had no idea what was wrong with me; I suspected the cause was a Vestibular Disorder, but for all I knew it could be a brain tumor or worse. The inflatable mattress in the image is where I spent the majority of my time during the following three months. On more than one occasion I crawled to the bathroom and back because it was too dangerous to attempt to walk even using a hiking staff.
Anticipated Completion Date: 11-1-16