TIMOTHY: I WAS IN THE AIR FORCE,
UH, FROM JANUARY OF '82 TO JUNE OF '92.
I WAS DIAGNOSED WITH MS IN 1989,
AUGUST 20, 1989.
CAMERON: MS VARIES A LOT FROM PATIENT TO PATIENT.
ONE PATIENT MAY HAVE SOMETHING OCCUR ONCE, TAKE A LONG TIME,
AND THEN MAYBE HAVE SOME MINOR SOMETHING,
A LITTLE NUMBNESS, 10 YEARS LATER.
SOME OTHER PATIENT MIGHT HAVE VERY RAPID PROGRESSION
WITH PROBLEMS WITH WALKING, PROBLEMS WITH VISION,
ANY WIDE RANGE OF SYMPTOMS.
SPENCER: AS THE DISEASE PROGRESSES,
UH, PEOPLE FIND THAT
EVERYDAY THINGS ARE MORE DIFFICULT TO MANAGE.
IT COULD BE FATIGUE, UM, EARLIER IN THE DAY,
UM, DIFFICULTY WITH BALANCE OR WALKING,
SOME CHALLENGES WITH SHORT-TERM MEMORY
OR FOCUSING AND ATTENTION.
CAMERON: I THINK OF TREATING MS IN A COUPLE OF DIFFERENT WAYS.
ONE OF THEM IS THE DISEASE-MODIFYING THERAPIES,
MEDICATION TO TRY AND SLOW DOWN THE DISEASE,
AND ANOTHER BIG PART OF TREATING MS
IS TREATING THE SYMPTOMS OF MS.
MITCHELL: THE VA IS ABLE TO PROVIDE A NUMBER
OF DIFFERENT SERVICES TO OUR VETERANS WITH MS.
SOME OF THE SERVICES OFFERED ARE BASED
UPON THEIR LEVEL OF SERVICE CONNECTION.
THE LEVEL OF SERVICE CONNECTION
FOR EVERY VETERAN CAN BE DIFFERENT,
AND SOMETIMES IT CAN BE A LITTLE DIFFICULT
TO UNDERSTAND.
UH, AND IT OFTEN VARIES AND DEPENDS
UPON WHEN YOU WERE IN THE SERVICE,
HOW LONG YOU WERE IN THE SERVICE,
WAS YOUR DIAGNOSIS-- UH, DID IT BEGIN--
YOUR SYMPTOMS BEGIN WHILE YOU WERE IN THE SERVICE?
AND SO TO HELP YOU BETTER UNDERSTAND THIS,
WE WILL OFTEN REFER YOU TO YOUR VETERAN SERVICE OFFICER.
THESE ARE REPRESENTATIVES THAT ARE TRAINED
AND UNDERSTAND, UH, THE COMPLEXITY
OF--OF SERVICE CONNECTION AND WHAT IT MEANS
FOR YOU AS AN INDIVIDUAL.
THE GOOD NEWS IS THAT WE CAN GENERALLY FIND SOMETHING
FOR YOU TO MEET YOUR NEEDS,
WHETHER THEY'RE SERVICES WITHIN THE VA
OR WHETHER THEY'RE SERVICES OUTSIDE OF THE VA,
IN THE COMMUNITY, UH, THROUGH THE COUNTY,
OR THROUGH OTHER VETERAN ORGANIZATIONS.
CAMERON: I THINK IT'S REALLY IMPORTANT
TO HAVE A MULTIDISCIPLINARY TEAM.
AS WE'VE DISCUSSED, MS IS A DISEASE
THAT AFFECTS A WIDE RANGE OF FUNCTIONS,
AND I, CERTAINLY, AS THE DOCTOR,
CAN'T BE THE EXPERT AT ALL OF THESE OR TAKE ON ALL OF THESE.
A LOT OF WHAT I DO IS WORK WITH THE TEAM,
WITH THEIR EXPERTISE,
WHETHER IT'S SOCIAL WORK OR PSYCHOLOGY
OR PHYSICAL THERAPY OR OCCUPATIONAL THERAPY
OR PROSTHETICS OR UROLOGY.
ANY OF THESE PEOPLE AND SOMETIMES OTHERS
WOULD COME IN TO HELP WITH THEIR SPECIALIZED KNOWLEDGE
IN MANAGING THIS WIDE RANGE OF SYMPTOMS.
SPENCER: TOGETHER, WE'RE ABLE TO LOOK AT, UM,
ALL THE PARTS OF YOU THAT CAN BE AFFECTED BY MS,
AND WE STAY IN TOUCH WITH EACH OTHER
AND WE'RE CONSTANTLY COMMUNICATING
AND TRYING TO FIND WAYS TO SUPPORT EACH ASPECT OF YOUR LIFE.
MITCHELL: AT THE VA MEDICAL CENTER,
WE HAVE THE PATIENT AS THE CENTER OF OUR TEAM,
WHERE THE OTHER TEAM MEMBERS, ESSENTIALLY, ARE CIRCLING
THE PATIENT, TRYING TO OFFER THE PATIENT THE SERVICES
THAT ARE MOST EFFECTIVE FOR THE PATIENT.
SPENCER: WHEN MEETING A VETERAN FOR THE FIRST TIME,
MY GOAL IS TO GET ACQUAINTED WITH THEM
AND FIND OUT WHAT'S IMPORTANT TO THEM.
WHAT DO THEY NEED FROM--FROM US?
WHAT DO THEY NEED FROM ME?
HOW CAN I HELP HAVE THEM ATTAIN
AND MAINTAIN THE BEST QUALITY OF LIFE?
FOR MANY MS PATIENTS, UM, ENERGY BECOMES A PROBLEM.
THEY FIND THEMSELVES GETTING TIRED THROUGHOUT THE DAY,
AND THEY'RE HAVING TO MAKE CHOICES
AS TO HOW THEY WANT TO SPEND THEIR ENERGY.
IT'S MUCH LIKE A BUDGET.
WE ALL HAVE A CERTAIN AMOUNT OF MONEY EVERY MONTH
THAT HAS TO GO AROUND AND TAKE CARE OF ALL OF OUR MONTHLY EXPENSES,
AND SO SOMETIMES WE HAVE TO MAKE CHOICES--
THAT WE JUST CAN'T AFFORD TO DO THIS.
IT'S VERY MUCH THE SAME WITH OUR FATIGUE.
WE HAVE TO MAKE CHOICES AS TO WHAT'S MOST IMPORTANT,
HOW DO WE WANT TO SPEND OUR TIME?
DO WE WANT TO SPEND OUR TIME CLEANING HOUSE
OR DO WE WANT TO SPEND TIME WITH OUR CHILDREN AT THE PARK?
MITCHELL: ANOTHER AREA, UM, THAT THEY COULD WORK ON AS WELL
IS WITH THEIR EXPOSURE TO THE HEAT.
UM, TOO MUCH HEAT CAN BRING ON A PSEUDO-EXACERBATION
FOR PATIENTS WITH MS, SO IT'S IMPORTANT
TO USE SUCH PRODUCTS AS, LIKE, A COOLING VEST
IF YOU'RE HAVING TO BE OUTSIDE IN THE HEAT,
AND ALSO NOT BEING IN DIRECT SUNLIGHT AS WELL
AND TO MANAGE THAT TIME AS WELL, 'CAUSE THAT COULD BRING ON
MORE FATIGUE FOR THE PATIENT.
STRESS IS ALSO ANOTHER MAJOR FACTOR THAT NEEDS
TO BE ADDRESSED AND MANAGED FOR PATIENTS WITH MS.
ALSO, THIS CAN INCREASE AND MAKE THEIR SYMPTOMS OF MS WORSE.
SO YOU MAY ALSO WANT TO TRY TO USE, UM,
DIFFERENT TYPE OF STRATEGIES OR TOOLS
TO REDUCE YOUR LEVEL OF STRESS.
TIMOTHY: THAT WHOLE THING OF LOSING THE MOBILITY--
IT WAS VERY GRADUAL.
UM, I'D WORKED SOMEWHERE WHERE I WAS
WALKING QUITE A BIT, AND BY THE END OF THE DAY,
I WAS DEFEATED.
CAMERON: SO WHEN WE TALK ABOUT ASSISTIVE DEVICES,
THERE REALLY IS A VERY WIDE RANGE--
ANYTHING FROM A CANE THAT'S PROBABLY
THE LEAST ASSISTIVE DEVICE,
ALL THE WAY TO A MOTORIZED WHEELCHAIR OR A SCOOTER.
AND THEN, IN BETWEEN, YOU MIGHT HAVE 2 CANES OR CRUTCHES
OR HIKING POLES, SO 2 SIDES,
A MANUAL WHEELCHAIR, AND THEN TO MORE POWERED DEVICES.
SPENCER: AS THE DISEASE PROGRESSES, IF IT BECOMES NECESSARY,
WE CAN MOVE ON TO, UM, WHEELCHAIRS
THAT ARE NOT LIKE YOUR GRANDFATHER'S WHEELCHAIR.
THESE ARE MUCH SMALLER, MUCH MORE ADAPTIVE,
AND MUCH MORE USER-FRIENDLY.
AND FOR THOSE THAT, UH, REQUIRE EVEN MORE,
AND WE WANT TO MAINTAIN YOUR SENSE OF INDEPENDENCE AND MOBILITY,
WE HAVE POWER SCOOTERS AVAILABLE, WHICH,
UM, ARE ACTUALLY PRETTY COOL NOWADAYS.
CAMERON: I WOULD SAY VA IS ACTUALLY EXCELLENT
AT LINING PEOPLE UP WITH WHAT THEY NEED.
THEY REALLY DO HAVE THE FULL RANGE AND
HAVE PEOPLE GO BOTH THROUGH PROSTHETICS AND PHYSICAL THERAPY
TO GET ASSESSED FOR WHAT DEVICES THEY NEED,
AND THEY MAY NEED A RANGE OF THEM, DEPENDING ON WHAT THEY'RE DOING.
I THINK WE SAW WITH MR. SARKER, HE SAID
AT HOME HE USES THE WALLS AND HIS FURNITURE.
WHEN HE WALKS FROM HIS HOUSE TO HIS CAR, HE USES A CANE,
BUT OUT IN THE COMMUNITY, HE USES A SCOOTER,
AND ALL THOSE THINGS WERE PROVIDED BY VA.
TIMOTHY: I HAVE A SCOOTER
THAT WAS SUPPLIED TO ME THROUGH THE VA.
I ALSO HAVE A LIFT IN MY TRUCK-- AGAIN, SUPPLIED BY THE VA--
THAT HELPS ME PUT THE SCOOTER IN THE BACK OF THE TRUCK.
IN A MATTER OF 2 MINUTES, I'M OUT OF THE GARAGE
AND INTO THE TRUCK AND GONE ON TO WHAT I NEED TO DO.
CAMERON: WHEN I SEE HAVING SIGNIFICANT PROBLEMS
WITH THEIR MOBILITY, THEY'RE--HAVE BALANCE PROBLEMS,
THEY'RE FALLING, I'LL OFTEN REQUEST
THAT BOTH PHYSICAL THERAPY AND OCCUPATIONAL THERAPY
GO TO THE HOME AND DO A THOROUGH ASSESSMENT.
THEY'LL TAKE A LOOK AT HOW THE HOME IS DESIGNED,
THE WIDTH OF THE DOORS, PLACES THEY MIGHT TRIP,
IF THERE ARE STAIRS WHERE YOU CAN BUILD RAMPS,
WHERE YOU COULD POTENTIALLY PUT BARS,
EITHER IN HALLWAYS, IN THE BATHROOM.
REALLY TRY TO OPTIMIZE THE SAFETY AND ACCESSIBILITY
OF THE HOME.
TIMOTHY: I HAD SOMEBODY, ONE TIME,
COME OUT AND LOOK THROUGH THE HOUSE.
THEY MADE SOME SUGGESTIONS. I FOLLOWED THEIR SUGGESTIONS.
AGAIN, WE'RE RENTERS, SO WE CAN'T MAKE
STRUCTURAL CHANGES TO THE HOUSE.
UM, HANDGRIPS ARE PLACED IN THE BATHROOM...
BUT THAT'S--YOU KNOW, AGAIN, THAT'S PRETTY MUCH IT.
WHEN THEY CAME FOR THE RAMP, THEY EVALUATED
HOW MUCH OF A RAMP I NEEDED AND SET IT UP.
IT WAS...2 WEEKS,
AND, UM, I HAD THE RAMP SET UP,
AND...IT MAKES ALL THE DIFFERENCE
AS FAR AS GETTING UP AND IN THE HOUSE.
IN THE HOUSE, I HAVE EVERYTHING PRETTY MUCH STRATEGICALLY PLACED
SO I CAN PUT A HAND ON SOMETHING IF--IF I NEED.
CAMERON: I THINK THAT MS CAN CAUSE EMOTIONAL ISSUES.
IT REALLY CHANGES-- IT OCCURS EARLY IN LIFE,
WHEN PEOPLE EXPECT TO BE AT THEIR MOST PRODUCTIVE AND THEIR MOST MOBILE
AND CAN TAKE THEM OUT FROM EMPLOYMENT,
CAN REALLY CHANGE THEIR RELATIONSHIPS WITH THEIR FAMILY,
CHANGE THEIR INCOME CAPACITY,
AND CHANGE THEIR ABILITY TO SOCIALIZE WITH OTHER PEOPLE,
JUST BECAUSE OF THE MOBILITY OR THE ENERGY DEMANDS.
SO IT'S REALLY A BIG CHANGE FROM WHAT PEOPLE EXPECT IN THEIR LIVES.
SANDY: IT WAS GETTING DIFFICULT.
HE COULD NO LONGER WALK THE STORES THAT HE WORKED AT.
HE HAD TO USE THE SCOOTER.
HE COULDN'T, YOU KNOW, KEEP UP WITH HIS JOB.
HE HAS THE COGNITIVE ISSUES,
SO HE WASN'T REMEMBERING HIS STUFF.
HE WOULD WRITE STUFF UP AND DOWN HIS ARMS, ON HIS HANDS
SO HE'D REMEMBER, YOU KNOW, WHAT HE HAD TO GET DONE FOR THE DAY.
HE COULDN'T GO OUT IN THE BACK AND THROW A TRUCK ANYMORE.
YOU KNOW, IT JUST-- IT WAS GETTING REALLY DIFFICULT,
AND HE WAS STARTING TO FALL A LOT AT WORK.
SO ONE DAY HE DECIDED ENOUGH WAS ENOUGH
AND HE...NO LONGER WENT TO WORK.
SPENCER: ONE OF THE MOST IMPORTANT WAYS THAT SOCIAL WORKERS
CAN HELP PEOPLE IN COPING IS, AS YOU EXPERIENCE LOSS,
UM, WITH DIFFERENT PARTS OF YOUR LIFE,
WE, UM, YOU HEL-- WE HELP IDENTIFY,
UM, WHAT CHANGES ARE HAPPENING IN THEIR ROLES.
MAYBE THEY'RE NOT ABLE TO, UH, DO THE THINGS THAT THEY USED TO BE ABLE TO DO.
SANDY: HE CAN NO LONGER... PUSH THE VACUUM AROUND.
HE CAN NO LONGER HELP OUT AROUND THE HOUSE.
UM, HE HAD TO GIVE UP HIS, YOU KNOW, WORKING.
WE USED TO LOVE TO TAKE LONG DRIVES AND GO PLACES,
AND IT'S--IT'S GETTING TO BE TOO MUCH FOR THAT, TOO.
UM, WE USED TO GO HIKING. HE CAN NO LONGER GO HIKING.
SO THERE'S BEEN A LOT OF CHANGES.
MITCHELL: AS THE PATIENT WITH MS, UM, PROGRESSES WITH THE DISEASE,
IT OFTEN CAN AFFECT THEIR MENTAL HEALTH,
THEIR RELATIONSHIP WITHIN THEIR FAMILY,
THEIR HUSBANDS, THEIR CHILDREN, AND OTHER FAMILY MEMBERS.
CAMERON: I THINK MENTAL HEALTH REALLY HELPS PEOPLE GAIN A PERSPECTIVE,
GAIN A PERSPECTIVE OF WHAT THEY DO HAVE,
AND GIVE THEM COPING STRATEGIES.
AND OFTEN, WHEN IT'S GROUP, I'LL PUT THEM IN TOUCH WITH
OTHER PEOPLE DEALING WITH SIMILAR CHALLENGES SO THEY DON'T FEEL SO ALONE.
SPENCER: I BELIEVE THAT WHAT WE HAVE TO OFFER THROUGH THE VA
REALLY CAN MAKE A BIG IMPACT
ON THE QUALITY OF LIFE FOR EVERY VETERAN.
WE HAVE A TEAM APPROACH.
WE'RE ABLE TO COME IN AND GET TO KNOW YOU AS AN INDIVIDUAL,
HELP IDENTIFY WHAT YOUR PERSONAL NEEDS ARE
FOR CAREGIVING, FOR EMOTIONAL SUPPORT,
UH, FOR PHYSICAL SUPPORT.
WE WANT TO MAKE YOUR HOME LIFE
AS COMFORTABLE AND ACCESSIBLE FOR YOU,
HELP MAINTAIN YOUR INDEPENDENCE,
AND HELP YOU FIND WAYS TO GET THE B--
THE MOST OUT OF LIFE.
MITCHELL: PLEASE DON'T THINK THAT THIS IS IT.
YOU CAN STILL LIVE A VERY FULL LIFE WITH MS.
CAMERON: CERTAINLY, I THINK THE SCOOTER HAS IMPACTED HIS ABILITY
TO INTERACT WITH OTHER PEOPLE, TO GET OUT OF THE HOME AT ALL.
HE, RIGHT, PLAYS WITH HIS GRANDKID, HAS HIS GRANDKID COME AND STAY.
HE COULDN'T DO THAT WITHOUT A SCOOTER.
SANDY: RIGHT NOW, WE HAVE OUR 5-YEAR-OLD GRANDSON HERE, AND WE'VE HAD HIM ALL SUMMER.
TIMOTHY: HIS OLDER BROTHERS HAVE SPENT SUMMERS WITH US IN THE PAST,
SO WE FIGURED THIS YEAR WOULD BE HIS SUMMER.
HE LIKES TO GO TO THE PLAYGROUND.
YOU LOOKED OVER THERE, TURKEY.
GRANDSON: NO, I DIDN'T.
SANDY: PAPA SITS IN HIS SCOOTER AND READS
WHILE ZACH PLAYS ON THE SWING.
HIM AND PAPA'S BEEN VERY CLOSE.
HE KEEPS PAPA GOING, KEEPS HIM OUTSIDE.
TAKES HIM OUT, YOU KNOW, TO GO TO THE PARK WITH HIM.
TIMOTHY: COME ON, YOU CAN DO IT! GOOD JOB.
SANDY: AND IT JUST KEEPS HIM ACTIVE.
CAMERON: I THINK THAT THE SERVICES VA PROVIDE
REALLY ALLOW PEOPLE WITH MS TO HAVE THE BEST LIVES THEY CAN.
SANDY: I THINK IT'S BETTER TO BE HOOKED UP WITH THE VA.
WELL, YOU HAVE THE SUPPORT, YOU HAVE--
IF YOU NEED HELP WITH SOCIAL SERVICES,
YOU HAVE SOCIAL SERVICES THERE AVAILABLE TO YOU.
UM...
IT'S JUST--I--I THINK THEY'VE BEEN VERY HELPFUL OVER THE YEARS.
TIMOTHY: A DIAGNOSIS OF MS IS PRETTY DEVASTATING,
BUT THERE'S SUPPORT GROUPS,
UM, SUPPORT THROUGH THE VA
THAT WILL IMPROVE YOUR QUALITY OF LIFE
AND HELP WITH EVERYDAY ISSUES.
SANDY: IF IT WASN'T FOR THE VA, WE COULDN'T DO IT.
THERE WOULD BE NO WAY WE COULD DO IT.