Lt. Colonel Diane Reppun, U.S. Army (Retired)

Lt. Colonel Diane Reppun, U.S. Army (Retired)

Diane Reppun

Women’s Healthcare and the American Veteran

Rank: Lt. Colonel (Ret.)
Branch: U.S. Army

At age 52, I was sent to Iraq. The Army chose to re-train me at Fort Bragg, North Carolina to become a Civil Affairs officer. At the time I had already spent 28 years in a combination of Active and Reserve duty in the Army. Field exercises included a twelve-mile road exercise in full combat uniform.

For anyone who has never done it, that means 40 pounds of gear not counting the weight of the weapon. Finally, I traveled to Fort Dix, New Jersey where I joined up with my Civil Affairs Functional Specialty Team. We spent about six weeks going through classes, exercises, combat simulations and weapons qualifications.

We deployed to Iraq in 2009 and spent the next 10 months working at Camp Victory, Baghdad. I didn’t go on patrols or on fire missions, but did have to travel armed into the Green Zone and we were subject to random missile attacks.

We were hit on New Year's Eve by one of those attacks. I had to throw my body armor over my head and run to a bomb shelter. In the process I injured my shoulder. A toxic battery fire burned for at least 24 hours just a few miles from my building and Container Housing Unit. The overall environmental conditions caused me to develop asthma. The doctors in Iraq said they thought it would go away a few months after I arrived home. It didn’t. This exacerbated all the injuries and strains on my body that I had endured during my training. It also aggravated the the punishment my body had taken after all those miles of road marches and all those relentless push-ups I had done for nearly three decades.
When I arrived back at Fort Dix, I was held over from returning home because of my shoulder injury. This was when I experienced the worst bureaucratic nightmare. The U.S. Army kept me at Fort Dix with no treatment for six weeks. I was finally transferred to a home-based warrior transition unit, still 800 miles from my home in California. Eventually, they transferred me to a unit close enough to my home that I could go home and get the surgery I needed as long as I reported to the unit and completed their paperwork requirements.

One of the requirements was that I apply for a VA disability rating. Having already had many medical tests and my complete medical records, with my Line of Duty paperwork completed, I was quickly scheduled by the VA closest to my home, for my medical evaluation.

Clinicians at the VA didn’t just evaluate my shoulder and asthma conditions. They did a thorough medical history and evaluated the long term damage to my joints after years of running and marching.

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Within about six weeks I had my 60 percent disability rating in writing and they told me to schedule an initial appointment to see a Primary Care Physician as soon as I was released from Active Duty.

Once again the Active Army let me down. They promised to keep me on Active Duty until my shoulder recovery was complete. When my mandatory retirement date (at 30 years service) came they gave me about a week’s notice that they had not filed for an extension. I was going to be cut off from all military services and medical support.

Luckily the VA was right there to take over.

I was given a great Primary Care Physician at the VA in Palo Alto. They immediately re-issued my prescriptions and scheduled any follow up appointments and regular medical appointments I needed. I was sent to Stanford Medical Center for Mammograms, at no cost to me. I was also referred to the Women’s Health Center and given any information I might need for medical and psychological support I wanted.

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More importantly for me, my disability payment started the first day of the month after my Active Duty orders ended.

So, my VA experience was outstanding, especially given the poor treatment I received from the Department of Defense. I suspect that a large percentage of young soldiers that have problems with the VA disability system experience those problems because of the inefficiency and poor processes the DoD has with transferring paperwork to the VA.

But to these soldiers it is all one big government mess, which makes it easy to just blame the VA.

I have a far clearer understanding of the problems and can say that I have been happily receiving all my care from the VA since 2010. I have a primary care physician. He treats me better than most other primary care physician I’ve had in the private sector, he takes the time to listen to me and I have had the same physician for over 8 years.

I never had one Primary Care Physician stay that long in the private sector. He tells me when I am due for a mammogram or Pap, puts it in the computer, and I get a call to schedule an appointment. Originally, when I started with the VA, I could call Stanford to schedule an appointment for a mammogram. They would send the result to my primary care physician. Everything was fine until the Choice Act appeared to muddy up the waters.

The last time I needed a mammogram, the doctor told me I’d have to go through the Choice program. I had no problem being referred to Stanford for anything that the VA Healthcare System could not offer me prior to this. Once the Choice Act started, I was given a general phone number to call to schedule a mammogram. They told me they did not have my information and would have to get back to me in a week or so. I called Stanford and they scheduled me the next day.

About 3 weeks later I got a letter in the mail with an appointment for a mammogram somewhere in San Jose, on a specific date and time; I was not even consulted. I called and told them to cancel it, but I got a call from the clinic asking why I didn’t show up.

I look at friends in their late fifties who have never been in the military. They are very concerned about how they are going to be able to afford healthcare when they retire. I am so happy that I have the VA. I also have friends who are already only able to afford Medicare, they share the problems they have had just finding a doctor who will take Medicare patients.

So when I am told that the possible result of privatization of the VA would be to ‘allow’ me to go to any doctor that takes Medicare, I am very concerned. Under this new scheme I would have to go out and find my own doctor. Then I, personally, would have to coordinate any specialty care to which I was referred. I would also have to reintroduce my providers to my military medical history, and hope that they understand because they may have never treated any other veterans.  

All of this scares me. I hope it never comes to that. I want to keep having the ‘Choice’ to get all my care at a VA medical center.

What I find in the VA is not only highly coordinated and integrated care. I find the same camaraderie I found in the military. You are in a waiting room or walk down the hall and see other veterans —sometimes someone you know—and you have a great time sharing stories with them. This has never happened to me at Stanford or at any other private sector hospital or physician’s office. 

 

History

Congress Established the Women’s Army Corp (WAC) in 1943. The need for a separate Women's Army Corps faded as women assimilated into male training, assignments, and logistics and administrative management. In September 1978, Congress passed Public Law 95-584 that disestablished the WAC as a separate Corps of the Army, effective Oct. 20, 1978. Women now account for nearly 14 percent (approx 182,000) of the active duty and 18 percent (approx. 144,000) of the reserve.

Definition

The Green Zone or ‘International Zone’ is a 10 square kilometer area within the Karkh district of Baghdad. It is where Coalition Forces located its chief area of operations after the 2003 invasion.

Care notes

Joint injuries and other conditions like tinnitus are common among most veterans. However, they can also be symptoms of a larger, undiagnosed issue. Unless a provider knows to screen for these issues, they may never be identified.

 

Cares notes & History

The VA was one of the first U.S. healthcare systems to develop women’s health centers that gave specific care from mostly female providers. For women veterans of reproductive age, the VA provides maternity care, contraception, a week of newborn care after delivery, and breast pumps.

 

Care Notes

Knowledge of Military Culture is a key measurement when determining if a provider is able to provide high-quality care to veterans.


Contributors:
Diane Reppun, Testimonial
Suzanne Gordon, Facts & Figures