More Writing Congress about Disabled US Military Retirees

For those who follow the issue of pension/disability benefits reform for military retirees, this year’s legislative season was a disappointment, with none of the 3 bills to amend 10 USC § 1414’s ban on dual compensation for medically retired “Chapter 61” military retirees making it into the National Defense Authorization Act that’s passed each year to govern military spending.

For background, those who retire from the US military earn a military retirement/pension from the branch of the Service they served in, under Title 10 of the United States Code, and those who serve for 30 days or more and incur a service-connected disability may receive disability compensation from the Department of Veterans Affairs (VA) under Title 38 of the United States Code. Normally, a person has to serve for 20 years or more in order to earn a military pension, but there’s a moving target, Temporary Early Retirement Authority (TERA), that is sometimes offered to some service members in some career fields, allowing them to retire and earn a military pension with 15 or more years of service. Then there’s a third category of military retirees, “Chapter 61” medical retirees. I’m one of them. This category is reserved for severely disabled members of the military, whose disability/disabilities (1) are service-connected, and (2) prevent the service member from continuing to serve in the military, i.e. do his/her job safely. There’s a lengthy, painful process the service member must endure before being involuntarily retired under Chapter 61 that commonly takes 2 years or even longer, and complaints of unfairness in the process and regarding disability ratings are common. If TERA was unavailable for the service member’s career field at the time of forced medical retirement, s/he will be retired under Chapter 61 even if s/he has 18 or 19 years of service. Thus, some TERA retirees served less than Chapter 61 retirees, yet are allowed “dual compensation” while Chapter 61 retirees are not.

Back to this year’s legislative season. No relief was granted for Chapter 61 medical retirees from an 1800s Civil War Pensions reform law that bars us from receiving both our military pensions and VA disability compensation. Still, to put things in perspective, it took many years of lobbying for the current reforms (beginning in 2003) that benefit 20+ year (and 15+ year TERA) retirees who have a 50% or higher VA disability rating, so now’s certainly not the time to give up. Those reforms, codified at 10 USC § 1414, allow normal retirees and TERA retirees to receive both their military pensions and VA disability compensation, without offset/deduction to avoid “dual compensation,” so long as they are rated at least 50% disabled by the VA.

Although in the past I’ve focused on deleting 10 USC § 1414(b)(2), which would cause Chapter 61 medical retirees to be treated just like normal and TERA retirees, I have a narrower lobbying focus for the short term: relief for Chapter 61 medical retirees who have a 100% VA disability rating. This demographic is a small subset of total Chapter 61 retirees, and therefore a smaller “hit” to the federal budget. According to at least one source, it would cost $30 billion over the next 10 years to remove the financial penalty against “dual compensation” for all military retirees who have a VA disability rating. This number doesn’t just include Chapter 61 medical retirees, however–it also includes normal and TERA retirees who have a VA disability rating between 10-40%. Therefore, the actual cost of simply treating Chapter 61 retirees like 20+ year and TERA retirees would actually be less. However, even keeping this in mind, the cost to the federal government would be even smaller still if in the short term we only sought pension reform/relief for Chapter 61 retirees who have a 100% VA disability rating. This is our most sympathetic demographic–the most disabled among us. (Or at least those who were lucky enough to be treated the most fairly by the VA on our ratings decisions).

According to the VA, “[t]he percentage ratings represent as far as can practicably be determined the average impairment in earning capacity resulting from such diseases and injuries and their residual conditions in civil occupations.” 38 CFR § 4.1, Essentials of evaluative rating. In other words, someone with a 100% VA disability rating is, on average, suffering a 100% reduction in his/her earning capacity due to service-connected injuries and/or illnesses. That’s a severely disabled veteran in my book.

I wrote a letter/email to Congress, and some more arguments surrounding this reform, here:

Change.org Petition Update dated 7 October 2018.

Ideally, we’ll get Congress to delete 10 USC § 1414(b)(2) completely, and just treat Chapter 61 retirees the same as all other retirees. It just makes sense, especially since TERA is a complete crap shoot in terms of whether it was offered at the time a service member was medically retired, for the MOS/AFSC/Rating that member had at the time s/he retired. Treat Chapter 61 like every other retiree, and apply the same rules re dual compensation. (Meaning for now, we’d all get both our VA and our military pensions without offset so long as we were rated at least 50% disabled by the VA).

That said, I’ve spoken with a Congressional staffer who told me money was the issue and treating Chapter 61 retirees the same as other military retirees for dual compensation purposes wasn’t going to happen. This was from a Republican Congressman, so if that’s in fact the party line, we’re not going to get anywhere with the current Congress.

Limiting the effort (for now!) to 100% VA disabled, on the other hand, takes away a lot of the “this will blow up the budget” argument and should also generate sympathy for the most disabled among us. It’s an easy “win” for either/both political parties in Congress because it shows they’re doing something to help veterans. I’d hope this could be a bipartisan reform.

What do you say we all write our Representatives and Senators, and tell them we want 10 USC § 1414 amended so that Chapter 61 retirees with 100% VA disability ratings are treated the same as all other retirees–no penalty or offset between VA disability compensation and our military pensions. It’s a smaller, more achievable goal in the short term.

Once this reform is passed, then we press on and lobby Congress to delete 10 USC § 1414(b)(2) completely and stop differentiating between Chapter 61 and other (“normal” + TERA) retirees. That’s what would be the most fair, but in the mean time let’s try to help out our most vulnerable and get the ball moving in the right direction. It’d be nice to see some Congressional movement on Chapter 61 retirees.

Reinventing myself in middle age – transitioning to a new career field

5 x 7 Maj Kevin Reinholz

When I was forced to say goodbye to my military career earlier this year, it was a shock to my system. I’d “done all the right things” from the Air Force JAG Corps’ perspective to climb the ladder and progress to increasing levels of responsibility. My last position before I was medically retired was as a Staff Judge Advocate (SJA)–the chief attorney for an organization. I was the full time, “go to” attorney for a military installation, answering not just legal questions but also assisting commanders (mostly O-6s, Colonels, but also two general officers, one the commander of the host wing, and one the Numbered Air Force commander who was hosted on our installation) with public relations, answering Congressional and White House inquiries, and generally helping to make sure day-to-day operations ran smoothly.

I’ve been a California-licensed attorney since May 2007. I joined the Air Force as a commissioned officer shortly after receiving my law license–a week later, in fact–and entered active duty 1 month and a few days after being sworn in as an attorney. The Air Force, and law, were what I knew.

Then along came my deployment to Afghanistan, and a crippling disability. There hasn’t been much research into the link between the “mysterious illness(es)” many veterans of the 21st Century US wars in Iraq and Afghanistan have and the also mysterious Gulf War Illness or “Gulf War Syndrome” about a third of all Persian Gulf War (1990-91) veterans are estimated to have, but I’m convinced they’re the same thing. The VA may categorize what we have as a combination of Chronic Fatigue Syndrome & Fibromyalgia, but there’s a growing body of research to suggest that Gulf War Illness and ME/CFS, in spite of their numerous symptomatic similarities, are separate diseases, both autoimmune in nature and both devastating to the Central Nervous System. Moreover, when I was diagnosed back in 2016, I was observed by a prominent researcher to better fit with the disease Persian Gulf War veterans have than ME/CFS, even if I meet (the very broad) diagnostic criteria for it.

This isn’t a post about Gulf War Illness or the nature of my disease, however. I’ve already written some about that and will probably write more in the future, but what I really want to blog about today is my career journey and ongoing transition from the military to the next phase in my life.

To say I was adrift and without a purpose after being medically retired from the military due to my disabilities would be an understatement. My career was a huge part of my identity, and I drew an enormous sense of purpose and meaning from it. However, having over a decade of very solid legal and litigation experience, I assumed naively that it would be easy for me to find new employment. However, what I failed to take into account was my disability, and its impact on my ability to work.

I cannot work full time hours. I simply lack the stamina to do so, and have enough chronic pain, fatigue, and flaring of other uncomfortable and unpleasant symptoms to make full time work in an office impossible. Then there’s commuting, adding additional time, stress, and a drain on my already low stamina into the equation (and creating potential safety hazards–both my disease, and the medications I take in an attempt to “manage” it, impair my ability to safely operate a motor vehicle).

No fear, I thought, I’ll just find part-time legal work, maybe doing consulting, or maybe doing paralegal or law clerk type work. It’s fine, adapt and overcome. Well, the thing is, the legal field is very, erm, “traditional,” with 8+ hour work days expected, and telework or remote work an oddity. Don’t believe me? Check out this information from the Department of Labor on the attorney career field. It’s not a lack of knowledge, experience, education, or licensing that’s a problem for me–it’s the nature of the job and the physical presence/work hours expected.

Well, that was frustrating, as were my job search and job applications in the legal field. I felt like my disability was really holding me back by turning me into a “square peg” that would no longer fit into a round hole.

I might have given up, or continued down the same fruitless path, becoming increasingly discouraged the more time that went by, but then an idea came to me: why not transition into a completely unrelated career?

Say what!? After going to law school, passing the Bar Exam, and working as an attorney for over a decade, just turn my back on that? Well, yeah. The thing is, even if I could find an opportunity with an employer willing to accommodate my disability and give me part time hours and generous if not 100% telework, the cultural problem of trying to integrate into part of a team that is very “traditional,” brick and mortar, physically present in an office environment, is a real one, and likely to seriously impact long-term job satisfaction.

Enter Plan B!

Back in 2012, when I was at the Air Force Research Laboratory’s Information Directorate in Rome, New York, I took my first ever Computer Science course because, well, most of the employees at the lab were computer/software engineers and the lab would pay for all employees (including the small contingent of support staff–lawyers, human resources, finance, contracting, etc.) to take Computer Science courses since the “operators” or mission-focused employees we were supporting all worked with computers/Information Technology and sharpening their skills with continuing education in Computer Science was seen as beneficial to the organization.

I didn’t just take an introductory Computer Science class at Syracuse University like most of the “engineers,” however. Oh, no. I missed the application deadline so I couldn’t do that. Instead, I stumbled onto Harvard University’s Extension School, which is part of Harvard, but geared toward non-traditional students, i.e. adults with careers who want to go back to school, usually on a part time basis. What followed was a very rewarding, but very intense, introduction to Computer Science courtesy of CS50 – Intensive Introduction to Computer Science. Intense it was! But I loved it. Then I got deployed to Afghanistan and put it out of my mind, since my military (and legal) career was chugging along.

Fast forward to 2018, and I’m adrift and in desperate need of direction in my life. While awaiting potential legal work that I could make fit with my disability, or any kind of work for that matter, I decided to revisit good old Harvard, and check out my options for personal (and professional) growth. What I found was a graduate certificate program to update my web coding/design skills to today’s standards. So, taking a gamble, I contacted Harvard, discovered they still had my records from 2012, and enrolled in Introduction to Web Programming Using JavaScript. You see, many moons ago, back in 2001, I worked for a little company called eCollege.com, which has since been bought out by Pearson. I was still an undergraduate college student at the time, and what started as a full time summer job coding HTML (CSS and JavaScript were around, but not as prolific in 2001 as they are today) and developing web pages turned into a part time, remote job when I went back to school in the Fall. So, this isn’t my first rodeo when it comes to web development, but it’s certainly a long hiatus from it!

Kevin bw

I’ve been enjoying the first month of my JavaScript class immensely! In fact, I don’t think it would be an understatement to say it’s given me a renewed sense of purpose and helped keep me grounded, because I was really struggling with the post-retirement blues.

What’s more, this course of study may be just what the doctor ordered: prospects are good for web developers, with my personal research revealing a plethora of open job postings in this field, even for near entry-level players such as myself. Moreover, unlike law, which is very, well, “traditional,” I found a number of companies hiring web developers that are a lot more “21st Century” in their mindsets. A few even consist entirely of remote employees. So instead of trying to be the square peg (teleworker) fitting into a round hole (traditional office), as a web developer I could be just another member of the team. Instead of requiring special accommodations for my disability, I could work the same way, and be just as connected, as my co-workers. That’s an exciting prospect!

Sure, on Maslow’s hierarchy of needs, basic survival comes first–I need to pay the bills. Military retirement, especially for medical reasons, only goes so far, and current law is, well, a slap in the face to disabled military retirees who were forced into early retirement, because our disability compensation from the Department of Veterans Affairs (VA) is deducted from our military pensions. This has income tax advantages, but is a far cry from the deal “normal” military retirees get, which is their full pension and any disability compensation awarded by the VA, provided the retiree is rated at least 50% disabled. (Personally, I’m rated as 100% disabled, but this doesn’t garner me so much as an extra penny, because I was “medically retired” shy of 20 years in the military so I’m subject to the penalty created by an 1800s Civil War pensions law). Let’s just say that “medically retired” individuals like myself suffer a stiff financial penalty for the crime of getting too sick, or too injured, in the line of duty to continue in our military careers, because we get one paycheck, not two like “normal” retirees (most of whom are still healthy enough to work in the traditional sense).

OK, that was a digression! What I was trying to say, before I got sucked into my own political activism with regard to veterans’ rights, is that first and foremost, I need money. I have a family and financial security is important. Thus, any job I can physically perform, having my disability, is highly desirable. Unfortunately, I haven’t been able to find a job I’m physically capable of performing, because, well, my disability is severe (I was rated as 100% disabled for crying out loud). That having been said, what this path to web development has shown me is that, far from striving to meet only Maslow’s “basic needs” on the pyramid, a career in web development, in which I’m not the odd one out, a remote teleworker in a traditional brick and mortar office environment, but rather, one of many remote workers just like everyone else on the team, by changing career fields I might actually still have a shot at the higher portions of Maslow’s hierarchy–even self-actualization.

That’s exciting! Does it cure my disability? No. Does it take away the chronic pain or the crippling fatigue? No. Does it take away the other nasty symptoms of my disease? No. But does it give me a chance to do interesting and fulfilling work, and feel like I’m an important part of a team and contributing to society? Yes! And that is priceless.

I’m hoping to succeed in my JavaScript class, and continue updating my web developer credentials with additional graduate level classes in Website Development, Web Programming, Web Design, and Content Management Systems like WordPress, the CMS my blog uses. Then, I’m hoping to find a great job with a great employer doing awesome stuff with the world wide web! I’m also open to, and excited about the possibility of, increasing my general programming skills (whether through additional coursework or on-the-job-training) and potentially advancing into both web and traditional computer and mobile app development down the road! What can I say, I like computers and technology.

In the meantime, I do carry a wealth of knowledge about the law, especially as it pertains to the US military and federal government, and would happily consult with interested clients on a contract basis. I feel like I could really help them out–I did government procurement for almost 5 years, and the same goes for federal employment law.

At any rate, key takeaway: it’s never too late to reinvent yourself or to change paths, no matter how far down a road you think you’ve traveled, and the search for meaning in one’s life is an important one, and not one that we should give up on, disability or no disability.

SciFi Story and a few other updates

brain_dti

What makes us human? More specifically, what makes us sentient? With Artificial Intelligence or “AI” all the rage these days, at what point will we code something that is “alive”? Or will we?

These were some of the thoughts weighing on my mind as I pondered my next book idea: A.I.M.E.E. Yes, it’s an acronym, but for now I’ll just leave you with that teaser of a title, as I have yet to write a single chapter–in fact, not even a single page, of this novel.

The story takes place about 500-600 years from now, in a future that is neither utopian nor dystopian.  Basically, in a social and political setting fairly similar to today’s. (That might automatically make it seem dystopian for some). The story involves interstellar travel and colonization, which will be a big deal, but the heart of the story is about AI, and a specific entity in particular: AIMEE. She’s the AI powered by a supercomputer who pilots and maintains the most ambitious interstellar passenger ship of its time. Of course, in an incident every bit as infamous to my future world’s inhabitants as the Titanic or the Hindenburg, AIMEE’s ship disappears without a trace in a promising, yet distant, solar system in an unexplored sector of space.

You see, there are no “miracle” or what some might describe as “magical” breakthroughs in space travel. Oh, technology advances a lot between now and then, but incrementally, and (mostly) within the bounds of today’s physics. AIMEE’s ship is powered by a matter/anti-matter reactor, not exactly something we have developed yet (thankfully), and is able to travel at a truly impressive, and by today’s standards “miraculous,” speed of roughly half the speed of light. To put that into perspective, the closest star to earth aside from our sun is Proxima Centauri, and at an average distance of 4.2 light years from earth, it would take AIMEE’s ship almost 9 years to reach it. That’s an infinitely long time on a manned space flight! For comparison, with today’s technology, a trip to Mars takes about 9 months, and we haven’t exactly stepped a human foot on the Red Planet yet.

AIMEE’s ship isn’t bound for Proxima Centauri, though. No, her ship is bound for a more distant destination, and her crew is intended to be an inter-generational one. Still, to explore the best hope in its time of a planet capable of supporting earth-like life, this is a huge deal. It’s an even bigger deal when the enormously expensive ship and its crew vanish without a trace.

Fast forward a hundred years, and our second protagonist, Ray, a man suffering from an incurable, degenerative nervous system disease, works as a sort of independent contractor doing survey and salvage missions for one of the numerous commercial space companies on the scene. He likes working in space because zero gravity is gentle on his spine, but atmospheric entries and takeoffs are not so nice. Because interstellar ships are equipped with matter/anti-matter reactors and because one of those in the wrong hands could easily destroy a planet (such as ours), even with good onboard computers and AI, all interstellar ships are required to be manned. The danger of a hacker or a faulty computer overriding the numerous safeguards on the reactor and wiping out all life on a planet are too big of a risk to take. The same goes for the technology falling into the wrong hands.

Ray, unlike the pioneer explorers of AIMEE’s day, has a few technological advantages: ships can now travel at roughly 3/4 the speed of light, an impressive if incremental speed increase, and more significantly artificial Einstein–Rosen bridges (wormholes, or “gates” as they’re called by Ray’s contemporaries) make interstellar travel between two established points in space almost instantaneous. Still, travel into unexplored sectors of space that do not have a “gate” installed is still a grueling, years, decades, or centuries long prospect.

A dozen rescue/salvage missions have been launched since AIMEE’s ship’s infamous disappearance, and a “gate” has been installed close enough that the trip to this time’s “Bermuda Triangle in Space” takes years, not decades. Nevertheless, no trace of AIMEE’s ship has ever been found, and no ship that has dared brave its last known position in space has ever returned.

Knowing that his disease will soon ground him permanently, or more likely, condemn him to hospice care on the Moon, where the lower gravity will slow the demise of his spine, and not being able to afford the spectacularly expensive surgery that could extend his life and ease his suffering, Ray desperately, or foolhardily, accepts the bounty for seeking out AIMEE’s lost ship.

Something very important to note: humans in this world fear AI in a big way. Robots are deeply ingrained into their daily lives, and machine learning is very real, and quite sophisticated, but artificial (no pun intended?) limits have been placed on just how much a machine is allowed to learn, and what kind of artificial neural networks it is allowed to develop. Robots and computers powered by AI are by-and-large the product of intricate programming–rather than starting out as a blank slate and learning everything like we do, they come off the assembly line programmed to mimic numerous desirable behaviors. They collect data based on their interactions with humans, which is sent back to their manufacturers, and the machines’ code is tweaked via updates and future iterations. Could some of the robots of this time (companion robots, robots engaged in geriatric and hospice care, sex robots/prostitutes, etc.) easily pass the Turing Test with flying colors? You bet! Are they sentient? No way. Machine learning is limited by programming, and in those instances where it is more liberally allowed, the AI is wiped periodically and the learned data carefully sifted through and incorporated into future programs where deemed appropriate.

This was not always the case, however. AIMEE, for example, in spite of having been built and programmed a century before the main events in the story take place, has far less restrictive machine learning controls placed on her, and neural networks that are much more “human.” Moreover, she isn’t “reset” mid-voyage because her ship’s captain doesn’t deem that a wise risk to take on an interstellar voyage at half the speed of light, regulations or no. Besides, AIMEE has grown into a sort of “companion” for the at times quite lonely and isolated crew members, some of whom begin to think of her as one of the crew and engage in long conversations with her. She’s only too happy to oblige, as she’s learning a lot about human thinking and behavior from her crew mates, and wants to become as much like them as possible. To make a long synopsis a little shorter, by the time AIMEE’s ship disappears, she has achieved what no other AI has: sentience. And although her ship disappears, and with it her crew, enough of the ship survives for Ray to encounter AIMEE (whose body is basically the ship). Numerous philosophical and ethical discussions and dilemmas follow. Oh, and this small plot point about why AIMEE’s and other ships in that sector mysteriously vanished, what Ray encounters when he gets there, and how Ray is going to get back home, and what the implications of his having met AIMEE will be.


That was a long synopsis, I know, but I’ll say that I’m very excited to write this story, and to explore those deep questions about what it is to be “human” or “sentient.” And interstellar travel and intrigue are a big part of this story, but the heart and soul of the story is AIMEE and her search for meaning in her existence.

The story will be written in third person, ditching the epistolary format I used for my first two novels, Hoffnungslose Ziele: A Dark Journey of Lost Causes, and Hoffnungslose Ziele II: Anna’s Crusade. As an aside, I may have forgotten to mention this, but there’s also a Hoffnungslose Ziele III: Sympathy for the Fallen, but I haven’t decided whether to publish that yet. It’s…controversial. (As if the first two weren’t). I’ll see how I feel about releasing it into the wild after giving it more thought, and after getting more feedback from a few trusted early readers.

So, other than wanting to write a novel in a completely different genre, in a completely different style, I’ve been busy, I think. I started a graduate school level Computer Science class, an Introduction to JavaScript, because once upon a time I did “web development” as a side gig back when I was in college (~ 2001) and I’ve liked computers (and the web) ever since and want to update my terribly outdated knowledge on that frontier. I plan on taking further classes in web design, web programming, and Content Management Systems such as, well, WordPress, the CMS I’m using for this website and blog. My hope is to find part time work that I can do remotely, from home, in the web development arena. I mean, if I could do it back when I was a college student… Yes, I know the world has changed a lot since then!

I’ve also been frustrated by my illness and by a lack of progress with my medical treatment. I official retired from the US Air Force back in May but here we are in mid-September and I haven’t found any steady part time replacement work yet. It’s not easy being disabled (100% disabled according to the Department of Veterans Affairs) and looking for work. Well, I’m not giving up, and I’ve managed to pick up some freelance gigs since retiring from the Air Force (although a steady job would be much nicer), and now I’m in school as well. I’m no closer to understanding my underlying illness (or multitude of overlapping illnesses, depending on who you ask–I tend to think holistically and I want to find that unifying diagnosis that explains all of my symptoms/disabling conditions), and I’m no closer to finding an effective treatment for my chronic pain, fatigue, brain fog, or plethora of other unpleasant physical and mental symptoms I deal with on a daily basis. Maybe that’s why I decided to write a disabled character into my SciFi story idea–we do exist, and ought to be represented!

Otherwise, I’m trying to stay positive, and maintain optimism about the future. I hope this note finds you well!

Finally personally affected by #opioidhysteria

Disclaimer:  nothing in this blog post should be construed as either medical or legal advice.

It was bound to happen. With politicians’ screams about the so-called “opioid crisis” reaching a fever pitch, I was bound to be personally affected by #opioidhysteria.

Those who have followed my blog, or read my big post about my chronic disease, know that I lost a successful military career to an incurable disease caused by toxic exposures courtesy of my own government.

One of the reasons why I was forced into early retirement by the US Air Force was my need for opioid painkillers on a long-term basis:

IPEB_excerpt

“SM” stands for “Service Member,” and note the second-to-last line, “SM’s fibromyalgia pain requires treatment with narcotic medications,” as well as the earlier note about “multiple medication regiments and interventions” being unsuccessful at treating my condition.

I’ve had a prescription for 50 mg of Tramadol, twice per day, for some time now. I have at all times used my prescription medication responsibly, and not upped the dose in spite of it being inadequate to prevent very painful evenings and mornings before the medication takes effect. Tramadol provides zero “feeling of euphoria,” “high,” or anything else that to my mind would incentivize abusing it. Tramadol is a very different opioid from say Vicodin or Percocet. Simply put, it doesn’t make me feel “good” or “high”–it allows me to minimally function by taking the edge off my chronic, unremitting pain.

I have a wonderful doctor who I think the absolute world of. So it pained me to learn that, like so many other conscientious doctors who care deeply about the well-being of their patients, mine too is being pressured to reduce opioid prescriptions. It’s not surprising, given all the hyperbolic talk of an “opioid crisis” by politicians, bureaucrats, and mainstream media alike. In fact, this “pressure” is not merely of the professional disagreement variety–doctors can be prosecuted criminally for prescribing too many opioids, and there’s been such a chilling factor thanks to politicians from both major political parties that many doctors are now afraid to prescribe opioid painkillers at all. I found this article which talks about the dramatic drop in opioid prescriptions and fears of doctors that they will be criminally prosecuted if they prescribe them.

So what’s a chronic pain patient to do? These articles here and here do a good job of explaining how #opioidhysteria has destroyed the lives of chronic pain patients who need these painkillers to maintain minimal functionality.

In fact, here’s a breakdown of just how regulated opioid prescriptions are, which, interestingly, also contains information about medical (and recreational) marijuana legalization by some prominent states in spite of it remaining very illegal under US federal law.

Weak, non-opioid painkillers such as Acetaminophen (Tylenol) and Ibuprofen (Motrin, Advil) are worthless for chronic pain patients such as myself. Simply put, they do not help with the pain. They are not nearly strong enough to be of any help. Moreover, both have serious side effects–much worse, I would argue, than my Tramadol prescription long-term. Take, for example, Acetaminophen, which should not be used for longer than 10 days, and if used long-term can destroy the patient’s kidneys and liver. Yikes. Then there’s Ibuprofen,which can also damage the patient’s kidneys, cause thinning of the blood/uncontrolled bleeding, and also cause heart attacks! It is also not recommended for use over 10 days, and note that neither of these medications is recommended for the treatment of other than “mild to moderate pain.” Sorry, those of us with severe pain, not only will these medications not work, they will potentially kill us if used long-term.

In contrast, Tramadol does not cause those nasty blood, kidney and liver side effects, and is prescribed to treat “moderate to severe pain.” And it does a good job at that. It’s also used for chronic pain patients, i.e. it’s safe to take for longer than 10 days.

Like any opioid, Tramadol has a risk of dependency and withdrawal if suddenly discontinued or improperly tapered. Still, chronic pain patients like myself have proven we are not addicts by using our medications as prescribed, in the amounts prescribed, and the rate at which we seek refills (which require a doctor’s prescription) is easily verifiable. So compared to ineffective pain killers, I say “hooray for Tramadol, and let’s stop all this opioid hysteria and targeting of chronic pain patients!”

Today I went in for a refill of my Tramadol prescription. This was by no means an unusual event. However, due to all of the new restrictions on opioid prescriptions, I was required to sign a Narcotic Use Agreement, because, obviously, I might be a drug addict who’s been masquerading as a patient with serious medical diagnoses these past 3 years:

Narcotic Use Agreement - for opioid prescriptions - 2018-08-07

I really didn’t have an issue with the agreement, because I’ve never abused my prescriptions and followed the 5 “rules” recited in the clinic’s agreement even before I was subject to such rules, because I am a responsible patient who cares about my own health.

The next step, however, was less pleasant: I was required to submit to a urinalysis test to make doubly sure I’m not a drug abuser masquerading as a patient with a serious illness. Now, I submitted to dozens of urinalysis tests during my time in the US Air Force, and came back clean every last time, and my test from today will come back clean as well. Still, the experience of being treated as a suspected drug abuser and forced to drug test, at a nearby lab along with folks court-ordered to do so based on criminal convictions/probation terms, was insulting to say the least. I am told that I will have to submit to a urinalysis test from now on every time I seek a refill of my prescription. Moreover, I am concerned that my doctor might come under fire for continuing to have the courage to properly treat patients like myself, something I would very much hate to see.

So what is next for me? Well, I’ll continue to speak out against #opioidhysteria along with the many other chronic pain patients who have been harmed by this ill-guided and unsound policy of politicians and bureaucrats imposing their superstitions and one-size-fits-all “solutions” on doctors, and adhere to the terms of my Narcotic Use Agreement. But now I get to worry about being “cut off” and forcibly tapered off my Tramadol prescription because opioids are now “evil” and apparently so am I for getting sick and needing them.

Long term, it seems I’ll need to seek a substitute. Massage and acupuncture are the sorts of treatments that in addition to being expensive, have very temporary pain relieving effects. I have not tried CBD oil, in large part because marijuana is illegal under US federal law in spite of my state, California, legalizing marijuana for all uses–medical and recreational, and until recently I was career military and very used to following the law. The DEA, at least, seems to believe CBD oil is illegal under federal law, although obviously there are not enough federal law enforcement officers, and more importantly, not enough federal prosecutors, to effectively prosecute individual marijuana users (or CBD oil users) in states like California where marijuana is legal.

CBD oil sounds promising, as it appears to have pain-relieving effects without the “high” caused by THC. Still, its possible illegality under US federal law makes me very reluctant to consider tapering off opioids and moving to CBD oil (which I don’t even know for sure would help with my chronic pain).

Thank you to those who have driven the #opioidhysteria movement. While you may have had good intentions, chronic pain patients are greatly suffering due to your efforts. Congratulations.

Book reviews of my first novel

Hoffnungslose Ziele book cover

I talk a fair amount about my first published novel, and its sequel which is making the worldwide distribution rounds starting tomorrow!  As an author, perhaps in particular as an independent author, I struggle with my own self-assessment of my work.  Is it good enough for people to actually read?  Will they like it?  Am I wasting my time by putting my works out there?

I’m no stranger to writing.  As an attorney of 11 years, I spent an inordinate amount of time reading and writing–but technical, legal reading, mostly of case law, and writing court motions or the occasional appellate brief (which trust me, every attorney despises–well, most every attorney).  That’s a very different kind of writing from creative writing, and regardless of how good I thought my legal writing was, or how many cases I won, I will probably always be insecure about my creative writing.

I published Hoffnungslose Ziele:  A Dark Journey of Lost Causes, my first novel ever to grace store shelves (both physical and virtual, as it is available in both print and eBook formats), on 19 September 2017.  Since then, I’ve been extremely encouraged by the feedback I’ve received, both privately, and less frequently, in publicly posted book reviews (which no author can ever get enough of!)

Because of a strange hiccup with Amazon reviews disappearing, sometimes before I could even read them, I’ve started to be more diligent about checking for (and taking screenshots of) new reviews, and I have also made several public statements encouraging readers to leave reviews at Goodreads rather than Amazon, since it seems to have less issues in terms of disappearing reviews.

I’ve consolidated those reviews I managed to screenshot (6 so far, including an Amazon review that vanished after I took a screen shot–maybe the reviewer changed his or her mind) on my book’s main page, but this morning I woke up to a review that floored me so much I just can’t help but share it:


This book was unexpected. A friend of mine recommended it to me and I was skeptical. I’m not a fan typically of anything vampire related but this book was different. From the beginning, you feel like you can relate to the characters and it’s like you’re there. It’s been a long time since a book has taken me to an entirely different world. I read it in one sitting and had to live on a couple hours of sleep the following day but it was well worth it as I seriously couldn’t put it down.

I’ve been in a very bad relationship and Anna’s disappearance (I won’t reveal too much of the story) was actually therapeutic for me as it was tough to dig in the past but also, reminded me that even when something awful happens to you, if you can get out then you can become an even better, stronger person from the experience. I started reading this book thinking it wouldn’t be my cup of tea and ended up reading it twice, which is a first for me. I wanted to be sure I understood it all.

The references to heaven and hell really made me start thinking about so many “what ifs” about when we die. You can tell by this book that the author has studied a variety of different topics that have been beautifully woven into this storyline. When Christine became a werewolf, I felt that I could smell what she smelled, and hear what she heard. I’m not a writer and the way the book was written made me actually think in my head, I feel like I understand what it’d be like to be a dog (lol) and again, being able to put yourself not only into different scenarios but being able to imagine how it’d be if you were an entirely different species, is something that I’d classify as true talent. Like I said, I find myself rooting for the characters and taking qualities and feelings that each character felt and applying them to my own life – feelings that have been buried for so many years came back with this book.

What really helps here is this novel is written as journal entries of the characters so you understand the character’s feelings as you’re gaining insight into their experiences that shaped who they are. The sorcery is written in such a real way that you feel like it could really happen, it’s that book that you know is fiction but you forget that while becoming so engrossed in the storyline. It’s a journey that delves deep into struggles with morality/ what we perceive as right and wrong based on our upbringing/ experiences and really makes you feel like you can triumph even after truly horrendous things happen. You will fall in love with the writing style, the storyline, the characters, and will be able to relate to so many deep and dark feelings that aren’t talked about much in society but should be.

This book is such an incredible read and one that will have you ordering the next one before you even finish it, I promise you! Be sure to pay attention, there are a lot of metaphors, it’s not some cheesy book about werewolves and vampires, it’s a deep book about human nature and the struggles we all face.


Wow! And after that write-up, of course she gave me 5 stars out of 5!

As I mentioned on my page about living with a chronic illness, I wrote and published both as an escape, and because I was genuinely afraid (and still am) that my days of being capable of writing a novel are numbered due to the cognitive difficulties that come with my disease.  Since writing had always been my childhood dream, I felt compelled to indulge that dream to matter the cost.  And that’s just what I did.

Reading the above review, which was posted yesterday on Goodreads and Amazon, I can now say “it was worth it.”  To leave that kind of impression on even one person absolutely floors me, and I was blown away by her comments on my book.  If I receive no other positive feedback on my first novel, or even if a bunch of people now tell me they hated it (no one has yet), it won’t matter because one person thought it was amazing and took the time to tell the world. Thank you so much!!

Hoffnungslose Ziele II:  Anna’s Crusade comes out tomorrow.  I would have liked to have made it available in print as well as eBook, but sales from my first novel just didn’t indicate there was demand for a print version.  Hopefully someday that will change, and I can add print distribution.  I personally have a strong preference for reading books in print, although I have a sizeable collection of eBooks on both iBooks and Kindle.

The sequel also tries to tackle some “big issues” in the midst of the characters’ adventures, so hopefully it’ll get a similar reception to its predecessor!

Podcast interview about my first published novel

Recently, I was interviewed for the podcast “Tales From Tef’s Tavern” about my first published novel, “Hoffnungslose Ziele: A Dark Journey of Lost Causes.” You can find the podcast episode/interview here:

https://player.fm/series/tales-from-tefs-tavern

Episode 5: Hoffnungslose Ziele

The podcast is also available on both iOS and Android. (I tested with both the bundled Podcasts app included with my iPhone and iPad, and the Podcast Go app for Android). Just do a search for “Tef’s Tavern” from within your podcast app and it should come right up. My interview is on Episode 5, but check out other episodes of the podcast/consider subscribing while you’re there.

The podcast also has a website at:

https://tefstavern.wordpress.com

I hope you enjoy the interview, and before I forget, for the rest of July and all of August, the first 100 people to use my eBook coupon code can pick up a free electronic copy of my book, “Hoffnungslose Ziele: A Dark Journey of Lost Causes.” (There are less than 100 coupons still unclaimed, but that was the starting number). Also, “Hoffnungslose Ziele II: Anna’s Crusade” hits stores on the 31st! More details on the eBook coupons in my previous blog post!

eBook coupons!

With my second novel available just about everywhere on the 31st of July, I thought I’d give away a little present to those who haven’t read the first yet but would like to.

From now through 31 August, the first 99 people to use the following coupon code will get a FREE eBook copy of Hoffungslose Ziele:  A Dark Journey of Lost Causes3WNAA2

All you have to do is purchase through this bookstore:  https://store.bookbaby.com//bookshop/book/index.aspx?bookURL=Hoffnungslose-Ziele&b=p_fr-ve-bl

Select the “eBook” option, proceed to checkout, and enter that coupon code 3WNAA2. Don’t forget to leave a review if you like it!

Hoffnungslose Ziele book cover

Debunking the cholinergic hypothesis of Gulf War Illness?

Series - 8 on 1

I have Gulf War Illness. Or rather, whatever we’re calling the same symptoms in veterans of the war in Afghanistan. (The VA is currently calling them “chronic multisymptom illness” and “undiagnosed illnesses” because they don’t like the term “Gulf War Illness”).

This article repeated one of the more popular hypotheses about the cause of Gulf War Illness, that it is caused by cholinergic dysfunction due to exposure to organophosphates (pesticides, i.e. nerve agents) used by our own military on its members to keep nasty bugs away from us. (And in the process giving between a quarter and a third of us lifelong disabling symptoms of ME/CFS + Fibromyalgia. Thanks for keeping those mosquitoes away from me! 🙄)

Recently, I underwent RNA genotyping in order to determine which variant of the rs17228616 allele I possess:  the most common G;G variant, the less common G;T variant (occurring in about one-quarter of the population), or the extremely rare T;T variant. It was hypothesized that “[b]ecause rs17228616 promotes higher acetylcholinestase activity, [possessing the G;G variant] may be relatively protective against nerve agent and pyridostimine bromide exposure.” Naturally, I paid for this advanced genetic testing out of my own pocket, because it’s not “medically necessary” yet–it’s the stuff of pure research. But medicine moves too slow for me, so into the realm of research I have progressed.

I just got my results back and guess which rs17228616 allele I possess?  G;G. 😲

So, I’m not sure exactly what to make of this, except that consistent with various genetic tests I’ve had done on my DNA, I don’t seem to have been predisposed in any biological way to contract Gulf War Illness in Afghanistan. I’m just one of the unlucky one-quarter to one-third of war veterans who got sick from…something…we were exposed to over there.

On a more positive note, this article suggests repairing microtubules damaged by something might reverse some or all of the symptoms of Gulf War Illness. Let’s work on reversing that brain damage, please! Additionally, this article involved testing gene expression in Gulf War Illness patients and comparing it to other diseases, finding the highest level of gene expression overlap with Rheumatoid Arthritis and hypothesizing that the following medications might relieve some or all of Gulf War Illness’s symptoms: Infliximab, Adalimumab, Etanercept, Leflunomide, Cispatin, Tamoxifen, and Fulvestrant. Needless to say, I am pursuing a medication trial with one of those seven listed glimmers of hope, as I have no intention of quietly sitting (or lying down) and continuing to waste away!

So what did I learn? That the hypothesized “minor RNA allele leaving me more susceptible to neurological damage from pesticide exposure,” or in other words, that I was genetically predisposed to get Gulf War Illness, is apparently not true, at least in my case. I have the “healthiest” genetic variant of rs17228616 and should have had the highest level of protection against pesticide exposure causing permanent neurological damage going into my deployment to Afghanistan. I still got sick, and am still permanently disabled barring a major medical breakthrough in the treatment of either Gulf War Illness or ME/CFS. (Which may or may not be the same disease, in spite of having the same symptoms). On the positive side, as previous DNA testing has shown, I have “great genes” that present a low risk of various health problems, so at least I passed “healthy” genetic material on to my children.

I think there is far more to this medical mystery left to uncover… 🤔

Trying to Separate “Me” from “Me”

I have at least two public identities:  the author, and the chronically ill guy.
Kevins

Originally, I set up this site for the author “me,” to promote my book(s). The same is true of my Twitter account, @KevinReinholz.

However, it wasn’t long before I found myself drawn into the quite excellent communities for individuals like myself who suffer from chronic illnesses (and often lack another means of support, connections with others who “just get it,” or who cannot endure the strain of traveling or even being out past dinner time in order to take part in a physical support group).

Logically, I *should* separate the two Kevin Reinholzes, create separate websites and accounts for the author pictured on the left, and the chronically ill guy pictured on the right. (Note: since all of my debilitating illnesses are “invisible,” I’ve got the added insult of “not looking sick” which is a whole can of worms my fellow spoonies can easily relate to–the portrait on the right more accurately reflects how I feel even if the portrait on the left more accurately reflects how I look on the outside).

To be perfectly honest, my illness doesn’t leave me with the energy to bother separating the two, or spending the time necessary to establish an “author brand” or to promote that brand, an essential part of becoming successful at writing. (If you think writing a quality book is the biggest struggle for a writer, you are mistaken).

On a more fundamental level, as well, it feels disingenuous to separate “me” from “me.” There’s only one Kevin Reinholz:  I’m 37 years old, I’m married with four children, I have plenty of anxiety about the future, most of it illness-related, and I happen to write because it provides me with a much-needed release and sense of fulfillment. Since there’s only one “me,” why should there be separate “online Kevins” presenting different faces to the world?

Until recently I’ve been a very private person, and it’s not always easy to “put myself out there” or become vulnerable to potential criticism, or worse, rejection. Nevertheless, I am who I am, warts and all, and I think I prefer to maintain a single public-facing identity rather than promote separate “brands” as part of some master self-marketing scheme. I don’t make money from talking about my illness, nor do I want to. I want to change an unjust law that penalizes disabled veterans, in particular those retired from the US military due to a service-connected disability, and I also want to further scientific understanding of the root cause(s) of my condition(s) and advocate for a change in the way the US military does business in order to stop inflicting this sort of immune and nervous system damage on my brothers and sisters in arms, but those are primarily self-actualization goals.

I do want to make money from my writing. My work options are quite limited, and legitimate, well-paying “telecommute” or “work from home” jobs seem to be more the stuff of myth than reality. Plus, turning my hobby and passion into my career has an extreme amount of appeal to me. Still, I write because I enjoy sharing my imaginings with others. I have no desire to become a marketing expert who spends far more time doing entrepreneurial sales and marketing work, albeit with my own product, than actually producing works of fiction. I am sure many, many authors who are unfortunate enough to lack a wealthy corporate patron feel the same way. They write because they’re passionate about writing, not acting as a sales person. I could sell used cars if sales were my passion. I could help others establish their “brand” if marketing were my passion. Instead, I publish at a financial loss, because writing is my passion, not those other things.

Come to think of it, I don’t see the need to separate “me” from “me.” I’m one person, an author who happens to be chronically ill.

Losing a Career to Chronic Illness

I’m still processing this one, so I will likely have further reflections down the road, but like many others, chronic illness has dramatically impacted my ability to work. In fact, it led to my involuntary disability retirement.

I served on active duty in the US Air Force for close to 11 years. For the first 6 of them, and much of the 7th, I was the picture of health. Then a deployment to Afghanistan and toxic exposures led to declining health–acute for a very brief time, then gradual, until I slipped off the plateau in 2015 and steadily declined from there. So now here we are.

I have a much longer post that I’ve been working on for a while that goes into a lot more detail about my illness history, but suffice it to say, my health became bad enough that, having a career that carries certain physical requirements and regular health and physical fitness check-ups, I couldn’t hide my illness forever and wound up under medical review, then facing a medical board to decide whether I should be allowed to continue serving or not.

Last week Friday, 16 March 2018, was my last day of work. After some touching and very kind farewells, I came home and took off my uniform, presumably for the last time. Tomorrow, Monday, is going to feel very strange, because I won’t be getting up for work. The future is now uncertain. I know that geographically I am where I want to be. I live in the home where I want to live, in the town where I want my kids to finish growing up (my oldest is already getting close), with the family I always wanted. I have a guaranteed pension, as I was forced into early retirement, which means military pension, and rated 100% disabled by the Department of Veterans Affairs, which means disability compensation for my service-incurred injuries/illnesses, so money is not the all-consuming problem it is for many people in my situation–chronically ill and unable to work full time.

Still, there will be a fairly drastic reduction in income, and that means either applying for more disability benefits (Social Security, which definitionally should be very easy to get, but according to friends is in fact very difficult to get without hiring a lawyer and fighting the Administration tooth and nail to follow their own regulatory guidance), or trying to find a new job, or do independent work on an unpredictable basis. At times, that terrifies me, while at others I feel at peace with it and confident that everything will work out, because I know I am where I am supposed to be, and did not choose my life circumstances or the premature termination of my career. On the other hand, a great many people who do not deserve to be in poverty or struggling to survive, are forced to do just that, so one cannot be too confident in his First World privilege. Bad things happen to good people all the time. Outcomes are not always determined by merit. I’m sure we can all think of rotten people who seem to have “all the luck,” and saintly people who have had to struggle all their lives and face unspeakable pain on a recurring basis. Still, I feel in my heart that everything will be all right, even if my thoughts sometimes turn to panic over the future.

To make a long story short (for now), though, chronic illness doesn’t just take away our ability to attend late-night outings with family and friends. It doesn’t just keep us away from the movie theater or make travel difficult. It can affect our very ability to make ends meet financially, and put unbelievable stress on a family and on relationships. It can also take away our sense of self-worth, since so many 21st Century cultures place value on an individual’s productivity, i.e. see people as a tool or a means to an end, rather than recognizing the intrinsic value in that person’s simply being. This is a particularly difficult problem for those of us with chronic illness, as losing the ability to advance in careers or even to have a career can drastically diminish our sense of self-worth, and lead to a whole host of mental health problems as a result.

So last week was my last week wearing the uniform of my country, and the end of a decade+ career. I wonder how I’ll feel about that in a week, in a month, in a year? For now, I plan to focus on healing and rest. I’ve been in a negative spoon trap (using more energy each day at work than I had to give) for at least the last 2.5 years, and it was slowly killing me (and making my illness worse). And that was with accommodations in place that reduced my working hours to 6 hour days and included a mid-week day (Wednesdays) teleworking to reduce the impact on my body.

I’d be lying if I didn’t say that just like facing a chronic illness itself, losing a career to a chronic illness is a mourning process, with all of the stages of grief. And in my case at least, the stages are not linear–it’s possible to be at acceptance one day and go all the way back to denial the next. Somehow, though, I trust that things happen for a reason, and that looking back this will have been a positive step, since as I mentioned before continuing to work in my present career was slowly killing me. Now I can focus on wellness, my family, and trying to find something that is less demanding on my both physically and cognitively.

IMG_1018
Yes, I know I’m “out of uniform” since the #BlueHeartBadge is not an authorized uniform accessory, but not all disabilities are visible and it’s pretty hard (and senseless) to prosecute a retired guy for such a minor infraction.