Reasons Not to Reduce the Patient’s Ratings

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Table of Contents

Medical Nexus
Personal Statement
References

Medical Nexus

Medical Opinion

It is at least as like as not (a 50%>/50% probability) that the patient’s current complications of gastroesophageal reflux disorder (GERD) are secondary to, related to, and/or aggravated by his service-related Unspecified Depressive Disorder (F32.9) with anxious distress. The complications include gastritis, H. pylori, and hiatal hernia, which explains the symptoms of recurrent epigastric distress with dysphagia, pyrosis, regurgitation, and substernal/arm/should pain. In this case, the veteran aims to prove that his condition has not improved during the last several years, and there are no clear and justified reasons for reducing his rating from 30% to 10%. Enough evidence may be found in the patient’s clinical findings, and scholarly articles will prove how dangerous poorly treated GERD can be.

Rationale and Nexus to Support Medical Opinion

When people report abdominal pain, heartburn, and regurgitation, they expect an appropriate assessment, diagnosis, and treatment. GERD is commonly diagnosed in veterans, and its severity depends on the service period and the offered recovery plan (Kent, 2021). In the given case, the patient underwent an upper endoscopy/esophageal dilation procedure several times in 2018 and 2021. The results include moderately severe reflux esophagitis (RE), 1 cm hiatal hernia, chronic erosive gastritis, and several normal parts of the esophagus (upper third and middle third) and duodenum (first and second portion). Prescribed medications are Omeprazole (40 mg) for the stomach, Metoprolol (25 mg) for blood pressure, Pravastatin (80 mg) for managing cholesterol levels, and more drugs to improve the quality of sleep, life, and mood. According to Hojo et al. (2021), the prevalence of RE may increase for a long time after the eradication of H. pylori, which causes gastritis in the stomach and other inflammatory processes. The rehabilitation period may usually cover more than three years, but some diseases remain asymptomatic (Hojo et al., 2021). The patient has to work with healthcare providers to control esophagus structural changes, new ulcer creation, and precancerous shifts.

Complications related to GERD are not always easy to predict, especially when the veteran’s rating is decreased and insufficient professional help is offered. The relationships between H. pylori, GERD, and intestinal metaplasia (IM) have been reported, but if IM is usually associated with GERD, H. pylori infection is not (Hall et al., 2018). Therefore, the presence of all these symptoms and conditions may provoke additional complications, including cancer. IM etiology remains controversial even at the normal squamocolumnar junction (Hall et al., 2018). Unfortunately, the risks for gastric cancer are usually increased if a person has IM. The reduction of rating, because the patient has shown some improvement, is not the salutation when a new diagnosis of IM is given. Such precancerous lesions are dangerous, and the patient should get a chance to observe any physiological changes and receive the necessary treatment.

Summary

GERD improvement is one of the most expected outcomes of any treatment plan but not a solid reason to reduce the patient’s rating, which leads to unwanted changes. If the patient feels relief from some symptoms, it may be explained by his high-level responsibility, following pharmacological and non-pharmacological interventions, and regular cooperation with doctors. As soon as the rating is reduced from 30% to 10%, as required by the U.S. Department of Veteran Affairs, interpersonal and professional relationships with healthcare providers will be damaged. The patient needs to get enough opportunities to undergo the required follow-ups and other procedures to reduce the growth of new risks.

Personal Statement

My military service was one of my life’s most amazing and defining moments. I got a great opportunity to develop my physical strengths, learn about loyalty and national security, and cooperate with the best people who remain devoted to their call. Unfortunately, even the best experiences may be associated with negative outcomes, which, in my case, was related to my health. Depression, GERD, hypertension, and intestinal metaplasia of gastric mucosa are the diagnoses I have gotten since 2018. During the last five years, I have visited hospitals, taken medications regularly, and followed doctors’ prescriptions to manage my lifestyle and physical activities. As soon as I was able to feel some improvements, Veterans Affairs made a decision to reduce my rating from 30% to 10%. I am not sure if this idea will bring positive results because the impossibility of taking the same steps and obtaining recommendations might affect my health and contribute to new risks.

Addressing the example of my military service, I think it is wrong to deprive soldiers of equipment or other vital resources when they demonstrate good results and gain victories. On the contrary, their achievements are highly appreciated, and new funding and opportunities are offered. In my situation, the possibility of improving my health within the offered rating system leads to reducing my rating. I still have many problems caused by depression and GERD, including intestinal metaplasia, gastritis, H. pylori, and hiatal hernia. I must deal with arm and shoulder pain by taking Ibuprofen and other medications regularly. My improvement is a result of cooperation with professional healthcare providers. I have doubts about the development of positive results if my rating is reduced. These numbers mean a lot to me, and I do not want to lose them just because I have succeeded in some areas. I need more time and support to maintain my well-being and deal with my health problems.