Letter to the Walter Reed Medical Board

President

US Army Physical Evaluation Board

Walter Reed Army Medical Center

Washington, DC 20307-5001

Re: Results of PEB, Convened on 02 June 2009

Dear Mr. _____,

I am concerned about the results of my recent Physical Evaluation Board.  I think I understand your concerns regarding my fitness for duty, and I agree that I am likely no longer fit for duty.  However, I disagree with some of the reasons stated on the DA 199, and I wish to present my case for consideration.

For as long as I can remember, I have wanted to be a soldier.  I was not born into a military family, but the Army always symbolized solidarity and honor to me.  The Army accepted nearly everyone, so even those who had nowhere else to go could find a home as a soldier, and it provided many ways for us to excel.  That is inspiring.  My family supported my joining the Army as a language analyst, though we all knew that would entail deployment.  Before I was even allowed to enlist, I—along with every recruit—underwent a complete evaluation at my nearest MEPS.  At no time during my processing was anything suspect discovered in my body.  If military doctors thoroughly trained to screen for physical and mental discrepancies were unable to find any issues with my back, ankles, blood pressure, cardiovascular system, or nuero-pathways, that leads me to believe that the problems were non-existent or minor enough to be invisible when I enlisted.

My back issues began a few weeks into Basic Training, sometime in early July 1997.  Though I would not exchange that experience for anything, as Basic Training taught me that I was capable of far more than I had imagined, some days it was hard for me to move properly after marching for hours or doing hundreds of sit-ups each day.  As I had never really done sit-ups prior to enlisting, I thought that feeling was normal even though I could barely walk upright sometimes.  (No, I do not know why I would think that would qualify as normal, but I am a big believer in working through challenges, so I mentally wrote that off as just another challenge to handle.)  After being seen by unit medics and doctors, they posited the theory that I was having difficulty adjusting to my new active life, and they prescribed Motrin and Flexeril.  I took both of those drugs until I graduated Basic Training in September 1997.

Approximately one month into Basic Training, I severely sprained my left ankle when I fell into a hole. We were on a several mile ruck march, prior to Basic Rifle Marksmanship training.  I continued on the ruck march until our Drill Sergeants had us stop for bivouac, when I explained to them what had happened.  After we returned to the company area the following afternoon, my Drill Sergeant sent me to the clinic to have my ankle checked.  After conferring with the doctor and with my Drill Sergeant, we decided that, in lieu of missing BRM, rolling back into a holding platoon, and restarting training, I would tape up my ankle, take more medication (including Tylenol 3), participate in BRM, and try to stay off my ankle as much as possible for the next six weeks, until graduation. I passed an APFT at the end of Basic Training, without a profile of any kind.

After graduation from Basic at Ft. Jackson, the Army sent me to California for the first part of my follow-on training.  While in California, doing required physical training, my back and my ankle started causing trouble again, possibly due, in part, to the terrain.  I was sent to the on-post clinic several times, and the doctors there started me on a regimen of weekly steroid injections into my back.  That helped stifle the pain in my back, and it helped improve my motility.  They also initiated my weekly physical therapy sessions for my back and my ankle.  Both back and ankle continued to cause me intermittent difficulties, and my command sent me to a specialist in orthopedic issues. They noticed small issues in my ankle and my foot.  Six months after I delivered my first son and eight months after graduation, in November 2009, I passed an APFT without a profile in order to continue my training.

Throughout my four months of training in Texas, I was recurrently on profiles for my back, my ankle, or both.  Shortly after arrival, perhaps partly due to the rather severe ‘reinforcement’ training we underwent as platoons, administered by another drill instructor, my back began causing difficulties again.  Some days, the pain would get so bad, it would shoot down into my legs, and I wouldn’t be able to sit at all or stand comfortably.  Sometimes, I hurt so bad, not even lying down would improve it. My muscles would seize around my thoracic spine and in my neck. I started having severe back spasms while on a field exercise near the end of my training.  My platoon sergeant took me immediately to a clinic where I saw a Doctor of Osteopathy.  After examining me, this D.O. told me that I had subluxation of the spine—mild-to-moderate in my lower back, moderate-to-severe in my mid-back and my neck.  He prescribed more medication, electrotherapy, and physical therapy.

Also while stationed in Texas, at my annual exam my provider referred me to a neurologist because I was having some difficulties with certain fine motor tasks, and certain involuntary bodily processes had ceased functioning one year prior.  After the MRI, I was told that there were some inconsistencies that could have been caused by head trauma.  (While we were in Basic, some of the Drill Sergeants would kick me in the head if they thought I was insufficiently focused while in our fighting positions during BRM.  Some of the side effects of the Flexeril that I was taking at the time are fatigue and loss of clarity and focus.  Those side effects can be compounded by other medications such as Tylenol 3.)  Throughout the remainder of my time in Texas, I participated in a modified PT program, easing the workload on my back and ankle while maintaining physical readiness. At the end of my training there, I was waived from taking an APFT due to a temporary profile so that I could complete the last portion of my follow-on training in Arizona without delay.

While at training in Arizona, I injured my right ankle when I fell down a hill while on a run during organized Physical Training.  I was treated at the clinic in our barracks building.  We did not take an APFT in Arizona, as we were not stationed there long enough.  I graduated in May 2000.

During our in-processing at Ft. Hood, TX, the medics administered a pregnancy test on me before having me receive any immunizations.  The test came back positive.  I chose to leave my career in order to raise two children with my then-husband and accepted a Chapter 8 discharge.  While I was undergoing out-processing at Ft. Hood in September 2000, I underwent the requisite medical screening.  After reviewing my records and giving me a physical, the attending physician recommended that I see the VA after my discharge.  Never at any time was I aware of being evaluated for a PEB.

I spent a little more than three years in the IRR after I left active duty. I received no notice of pending Medical Board action, though I did receive a notice that I had to fill out the SF 86 to renew my security clearance.

I renewed my enlistment contract in December 2003, accepting an assignment as a drilling Reservist at the ATCAE Augmentation Detachment on Ft. Meade, MD.  In August 2004, I re-enlisted as a drilling reservist, after having passed an APFT while not under profile.  In late 2005, I began the process for my five-year physical.  I was processed at the Ft. Meade MEPS, where one of the doctors referred me to Bethesda National Naval Medical Center for further evaluation for my back, my vision, and my heart.  In August 2006, I received an email from HR St. Louis, indicating that I needed to undergo an evaluation, but I received no further information from them.  I thought that they were just waiting on my physical to get uploaded into the system.  I never received a DA 3349 from them.  The physical that the physicians at Bethesda wrote up for me was 111111.

In November 2006, I collapsed while running an APFT at Ft. Indiantown Gap during my Warrior Leadership Course. At the time, I was platoon leader.  From what I understand, the combat medics attempted to treat me at the scene, but I was unresponsive.  An ambulance was called, and the paramedics took me to Hershey Medical Center where I was admitted and where I remained for two days.  The doctors and physicians’ assistants who evaluated me told me it appeared that I had developed Atrial Fibrillation and that it was compounded by my low blood pressure.  They were also concerned by what they considered abnormal activity in some of my brain waves.  As I did not live in the area, they recommended my disenrollment from training, so that I could return home and see my regular practitioner immediately.  I have not taken an APFT since that time because of my illness.  The doctors have been trying to decide the best ways to treat me.  I have never been issued an updated DA 3349.

In July 2007, I collapsed after morning formation while walking back to our building.  Someone called the ambulance, and I was taken to Baltimore Washington Medical Center.  The paramedics stated that I looked like I had a stroke or a seizure.  After blood work and EKGs, the attending doctor noted that my heart rate was severely irregular and I should get evaluated for Atrial Fibrillation.

Over the next year, I was admitted to the hospital three more times.  In June 2008, I was walking around St. Paul, MN with my family when I had to be rushed to Hennepin County Medical Center via ambulance because I was experiencing crushing chest pain and had stopped breathing. In July 2008 while at our unit Battle Assembly, I was again rushed to Baltimore Washington Medical Center from Ft. Meade for the same symptoms.  In September 2008, the paramedics treated me on scene at my drilling unit and relieved me from duty for the weekend.

Finally, in October 2008, I collapsed while at an APFT for our unit.  The paramedics were called and took me to Laurel Regional Medical Center.  I was at the hospital for five days.  After the plethora of tests the multitude of doctors ran on me, they diagnosed me with Atrial Fibrillation and with Complex Partial Seizure Disorder.  My neurologist says that the seizure disorder is not something that is genetic.  It is not innate; I was not born with it.  She says it was something that was done TO me and has since become worse.  Most likely, it was incurred during Initial Entry Training and aggravated thereafter.  I currently have to take 2000 mg of Keppra XR every day, and both my neurologist and my electrophysiologist have mentioned the possibility that I will need more medication in the near-future.  I have to have an Electrophysiology Study done next week at Johns Hopkins Bayview Medical Center.

I had never had any issues of this nature before I joined the Army.

After I left Active Duty, my back was beginning to feel better.  I have been seeing a chiropractor on a relatively regular basis, and he has noticed great improvement in my mobility, alignment, and pain management.

However, my seizure disorder may never allow me to be completely normal again.  Currently, I cannot drive.  I understand that having seizures that may not be completely controlled by medicine means that I am likely undeployable.  Were I to have a seizure, I could get someone killed, and that is not an option.

Also, I had received notification in March 2008 that I was being processed for PEB via the 81st RSC in Alabama.  I sent them all my information at the time, along with the letter from my Commanding Officer at the time.  I do not know what happened to that paperwork, as it seems to have vanished around the time that our unit was transferred back under purview of the 99th RSC.

I have spent most of my adult life as a soldier, and as a language analyst.  I love my job, and I have performed at levels higher than my rank for much of that time.  I was our Assistant Command Language Program Manager for years.  I have been squad leader, class leader, platoon leader, and acting team NCOIC.  I do not believe that my now-mitigated back condition should disqualify me from service, but I can understand how my seizure disorder would disqualify me from deployment and thus from the Army.  All I ask is that you review my supporting documentation.

Thank you very much for your time and consideration.  Have a wonderful day!

Sincerely,

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