I was contacted by the father yesterday of one of the men who died here and he had me type up a time line using the progress notes we got from the VA to send to the Inspector General of the VA. I was told when I called the IG that even though the Inspection that was done on two of the men who died came back inconclusive or with no findings of fault that does not mean there is not a problem with the care or medications. If no one reports, they will not catch this.

So below is my Time Line if anyone cares to read it. The thing that bothers me the most is this denying crap. I gave them Red Flags concerning my husbands well being, yet they were not listening, only listening to my husband, who could not see what I was seeing. It amazes me!



Dear Representative 32:
vaoighotline@va.gov

Below is a basic time line of what we feel has been a serious issue concerning my husbands care and treatment for his PTSD since 2006.

When my husband returned from Iraq in March of 2005 and before his retirement from the Army National Guard in 2006 I began seeing changes in his behavior that ranged from angry outbursts, problems sleeping, nightmares and fear of noises etc. It was at that time we sought marital counseling through Kanawha Pastoral Services and tried to figure out what was going on. We were told at that time to seek help through the VA.

It was sometime in the early part of 2006 my husband began getting help through the VA. "Referring to the copy of all his progress notes we have treatment notes begin in 5/06."

My husband's medical conditions known at that time were Asthma of which he was prescribed and was taking Singular before bed every night and carried a puffer and used when needed for breathing problems. His military records included past documented history of clinical depression and past suicide attempt while in the military.

Progress Notes: June of 2006 the VA Clinic in Charleston WV began a medication treatment for his PTSD symptoms and possible depression consisting of Citalopram Hydrobromide (Celexa) 20 mg BID, Quetiapine Fumarate (Seroquel) 25mg QHS and Clonazepam (Klonopin, Rivotril) 1mg QHS

Immediately after he began this "treatment" I noticed a huge increase in what I suspected was over sedation but being he was under care I thought may be in time it would level out. My husbands mood seemed to improve a bit being he was more catatonic then normal and he seemed to be confused or more forgetful then normal. I also began noticing when he did fall asleep at night or after work it was difficult to rouse him for any reason. He had an extremely difficult time getting up for work at 6am and told me he had almost fallen asleep driving numerous times. His breathing at night became louder more snorting and times I thought he may have stopped breathing. The increase in snoring was so bad many nights the only way to get sleep myself was to constantly make him roll on his side at night.

My husband began loosing interest in the family, his hobbies, was acting paranoid at times, and his behavior was not only confusing for me and the kids but scary at times. He almost fell asleep driving with the family in the car that I began driving instead of him if the family went anywhere and continue to do that to date.

Progress Notes: 8/2/2006 due to the extreme sleepiness, erectile issues and issues my husband was having with nerves the Charleston clinic started him on Bupropion hydrchloride (Wellbutrin/Zyban) one 75mg tablet every morning.

It was at this time I began noticing another increase in his PTSD symptoms and the continuing sleepiness or over sedation. Anger outbursts became more frequent, his snoring continued and I feared he might stop breathing at night. I began complaining to him I thought he was overly medicated which caused problems between us. I was confused as to "what" treatment he was actually getting but this being his medical care I was not informed.

Progress Notes: November 02, 2006 the Charleston clinic lowered his Seroquel and told him to cut his pills in half. The pills were still in the 25mg form, but he was to use a pill cutter to get the proper doses. He was still on Celexa 20mg BID, Wellbutrin 75mg Qam, Seroquel 12.5 mg Qhs and Clonazepam 1mg Qhs.

I began suspecting it was the Clonazazepam causing him the most issues based on even cutting the pill in half was not helping. By this time his symptoms had increased to bed wetting, which he was highly embarrassed to tell anyone, and sleepwalking. I was watching and monitoring both the night time medications to make sure he was not taking more or cutting to large of a piece then he should based on his serious sleepiness, mood changes and forgetfulness. I did not find him to be abusing these medication but his mood and behavior was not improving and the sleepiness was getting worse.

In late December 2006 after he had wet the bed again and the last straw for me was finding he had sleep walked into our younger child's bedroom sometime in the middle of the night and was sleeping in that bed. It scared me so bad I told him if he did not call the doctor I was going to call and report the bed wetting incident. He placed a call on Jan 2007 per notes to request stopping the Clonazepam.

Progress Notes: Feb 7th, 2007 the doctor decided to stop the Clonazepam due to over sedation per notes but he was to continue other medications.

By this time our marriage was having more serious problems due to his PTSD symptoms, medications and the side effects it seemed he was always tired no matter how much sleep he got and I started wondering if he was telling the doctors about these things. I still wondered if he was over medicated and what other "therapy" was he getting besides medication? My husband was more and more distant that I even suspected he was having an affair, this did not help our relationship nor the family.

Progress Notes: 3/29/2007 There is noted in progress notes of a suicide call or report concerning my husband that was taken by the staff at the Charleston Clinic with the Sheriffs dept coming to my home to check on my husbands well being. I was unaware of any suicide threat and my husband was later found to be at work and fine. It is possible he had been thinking about it due to my threats of divorcing him during this time frame due to the relationship issues this was causing the family and our marriage.

Progress Notes: 5/24/2007 was one of many telephone calls I would make to the clinic and began voicing my concerns about over medication and behavior speaking with his therapist who appeared to not have any issues at that time in addressing my concerns and in fact confronted my husband at that counseling appointment later that day of my concerns.

Progress Notes: 6/18/07 My husband was seen for 20 minutes for treatment of PTSD per notes , in the notes there are medications showing my husband was taking of the following:

1.Azithromycin 250mg tab take two tablets by mouth

2.Bupropion HCL 75mg Tab take one tablet by mouth every morning by mouth for mood or smoking cessation

3. Citalopram Hydrobromide 40mg Take 1/2 tablet by mouth twice a day for mood

4. Gentamicin Opth Soln .3% Instill 1 drop in left eye 5 times a day

5. Ibuprofen 800 mg tab take one tablet by mouth 3 times a day for pain or inflammation

6. Montelukast NA 10mg tab take one tablet by mouth every evening for asthma

7. Quetiapine Fumerate 50 mg tab take one-half tablet by mouth at bedtime for mood.

Progress Notes: June 20th, 2007 a note can be read concerning increase in medication done by John Hipes a doctor at the Charleston Clinic. He recommended an increase in my husbands Celexa from 40mg daily to 40 mg Qam and 20 mg every evening. He was to continue taking the 75mg Wellbutrin in the morning and in the notes and I am not sure when the medication Seroquel went from 12.5mg back in November 2nd 2006 back up to the 50mg pills and my husband cutting them in half again to take that half pill at night.

Progress Notes: July 19th, 2007 my husband medical review for his disability was done in Huntington

Progress Notes: Aug 2007 aggressive behavior and sleepiness continued.

I was overwhelmed with me taking over most of the home chores, child rearing, bills, driving and this added more stress. At no time did I get any calls from the VA to possible follow up on behavior or meds etc...

Progress Notes: September 18th, 2007 per notes his medication for Celexa was changed from 40 mg in am and 20 at night to 40mg in the morning and another 20mg at noon.

Progress Notes: September 20th, 2007 per notes, at the VA Charleston clinic gave patient some 25mg tabs of Quetiapine to try a 12.5 mg dose and see if this still effective without daytime grogginess.

Thanksgiving day 2007 my husband during a heated argument pulled a knife and threatened me with the knife. I called the Charleston VA clinic sometime after that incident to again voice my concerns about his behavior, sleepiness and forgetfulness and what I felt was him being over medicated.

Progress Notes: 1/16/2008 my husband discussed his concerns about his sleep and skin. Requested a sleep apnea test to be done. Notes as to his serious snoring where he was trying breath rite strips to help are noted. Heart palpitations, nightmares, anger issues. No sleep apnea test was EVER ordered until recent request Jan 14th 2009.

This test was only ordered after getting an outside civilian doctor to recommend one and we brought the request on December 18th, 2008 and Jan 7th, 2009 appointments for us to be told both times to bring it to the Jan 14th, 2009 appointment.

Of course during this time things had gotten terrible and we were fighting everyday almost, him yelling at his job, the kids, me and I was fed up! I began searching the Internet for help and support from others to deal with his moods, behavior and medication issues. I researched everything I could on PTSD and this upset my husband when I tried to discuss this with him. He did not want me involved and blamed me for all his issues. I began suffering medically and emotionally as did our children. He became more and more physical in chasing me around when made and making threatening gestures, things he NEVER did since we began dating in 1996. This was NOT MY HUSBAND! I did not know who he was anymore.

Every month it seemed he would tell me another doctor at the VA Clinic was gone and they had a new one. Medications seemed to just come in the mail at weird times and we even got two bottles of Motrin 800 mg from the VA each bottle having 270 tablets in them...more Motrin then I could take in a year!

In fact we still have both bottles one issued in May 2007 and one in July 2007

I did not see my husband using more medication then he was prescribed being I was watching at this point and that made him mad to. He hated me treating him like a child as he would say. He did not realize I was frustrated and scared of his condition and his health and my own.

Progress Notes: 3/4/2007, I called the Charleston clinic and spoke with Mary Smith telling them he was getting worse, how he is even more agitated, irritable violent and I was afraid and at my wits end. He was drawing his fist back like he wanted to hit me more and more. Reported he was more forgetful that I felt the meds were not working he might loose his job. Their answer was marriage counseling suggested.

The person I spoke with at the clinic called my husband at his job to confront him about the call from me and it was then my husband stated he did not want anymore information shared by them with me. He assured them he was fine. This caused more problems for me and our relationship.

Progress Notes: 3/14, 2007 per notes Advocate George Brawn called Charleston clinic after receiving a call from me requesting help. Marriage help was not an option being my husband was not willing and this would only be available through the VA, not outsourced and covered by the VA being they had marriage counseling avail, though not at convient hours for either me or my spouse.

Progress Notes: March 20th, 2007, some confusion in the notes about Celexa dosage. Appears Doctor Moxness from the Charleston clinic may have told my husband to increase his medications on a 3/13/2007 appointment, though no notes in file for that date.

He was taking Celexa at the dosage of (1) 40mg tablet in morning and (1) 40 mg tablet at night now along with his other medications.

Progress Notes: April 4th, 2007, I went to my husband job to share lunch with him at his desk with our 5 year old son. After an argument and my refusing to leave at that moment he grabbed my throat and attempted to strangle me in front of our son. This began a series of even more problems for us. It was at that time a protective order was filed and granted allowing us to only have contact concerning the children and during counseling.

Progress Notes: April 8th -April 10th 2007 notes are add in's done on May 11th 2008 at 15:25, they are very inaccurate and not a real picture in anyway of how things actually happened or of what was said.

There was not an appointment scheduled On April 8th as stated in the notes. The appointment was April 11th at the VA clinic after my husband called them, though the notes try to say I went there on the 8th. I did not see SW Richard until April 11th, 2007.

From March 2008- May 1st, 2008 per notes my husband was not seen.

During the time frame of April-July 2008 my husband and I began seeking marital counseling in the evening as well as I began seeking treatment for depression. During this separation the friends he was staying with did not note him deviating from his medication, but did notice his behavior was not good nor his thinking at times. I noticed he sounded more drugged up during telephone calls, still was sleepy, more paranoid, stressed out and I continued to call the VA Charleston with my concerns that he might hurt himself or others.

The VA notes from May- November reflect an inaccurate picture of how I acted. I was highly upset yes, but they do not make note of the valid concerns I was trying to make. Suddenly more medication were coming via the mail to the home, my husband still seemed over medicated and his dosages were increased. He appeared possibly suicidal based on information he gave me and others and his calling the suicide hotline numerous times as can be noted on May 30th, 2008.

Progress notes: from are limited to non existent but I do see that in June 2008 and July 2008 reports note he has called the suicide hot-line numerous times. I am not sure when his medications were actually increased again being he is not being seen regularly during this time even though his stressors have increased. Based on the progress notes his medications as of 8/4/2008 were as follows:

Citalopram 80 mg Qam, Quetiapine 50mg Qhs (bedtime) and Wellbutrin 75mg Qam

My husband returned home in July and we began working on our marriage and trying to take steps to get proper care for his illness. In September the Kanawha county court agreed with me in getting him an outside evaluation away from the VA clinic and evaluating his medications as well as attending 32 weeks of domestic violence classes as the terms to dismissing his case.

Progress Notes: After September 3rd, 2008 to December 1st, 2008 there are no progress reports in our file. It appears that my husband is being seen one time per month on average since April 2008, even though his behavior has increased in irritability, violence and excessive sleepiness.

Also it was not until the court order and we began seeing another outside counselor that my husband begin accepting there might be a serious issue with his medications and care with the VA. At least he appeared open to investigating that finally. I also made a few calls asking the VA as to what actual "therapy" was my husband getting (so infrequently) besides medication to help in his PTSD? I never have gotten a straight answer except the standard, he is getting therapy but if he is that bad have him committed if you feel he is a real danger to you or others, or he can go to the Clarksburg PTSD program.