- The Washington Times - Tuesday, November 16, 2010

Dear Sgt. Shaft:

I was married to Albert H., who retired from the Air Force. We were married in 1996. At that time, I acquired my military ID and Privilege Card. Albert passed away in January 2002. I then remarried in 2006 (and so I lost all my commissary and BX privileges).

Now that I am getting divorced, once that divorce is final, can I think reapply for my widow’s benefits? There is no pension involved (we both also retired from the IRS) and no Social Security, so the only thing I would like to reinstate is my ID and privileges card. If I can, what paperwork (other than my expired ID card and copy of my divorce decree) would I need to bring to my nearest military base?

Hopefully, you can help me with this — this remarriage was not a good move.

Sincerely, Sally M.
Via the Internet

Dear Sally,

Those in the know tell me that you can get your ID back, with commissary, exchange and MWR privileges. However, you cannot get medical benefits back; they are lost forever.

You should bring your old ID card, the divorce decree and at least one other form of ID (passport, driver’s license, etc.) to the nearest military ID issuing office, which can be determined from this web site: https://www.dmdc.osd.mil/rsl/owa/home. It’s always a good idea to call ahead to the facility and make an appointment to see if there are any local requirements, and to determine how you can get on base to get your military ID.

Shaft notes

According to a recent Department of Veterans Affairs (V.A.) study, patients taking warfarin, a widely used blood-thinning pill that requires careful dose monitoring, have similar outcomes whether they come to a clinic or use a self-testing device at home. The findings, published in the Oct. 21 issue of the New England Journal of Medicine, are good news for heart patients who live far from clinics or are homebound.

“This study helps answer an important question for cardiologists, primary-care physicians and other health providers, and will lead to improved care for their patients,” says V.A. Chief Research and Development Officer Dr. Joel Kupersmith, himself a cardiologist. “The results are significant for a great number of veterans currently receiving care through V.A.”

Traditionally, doctors, pharmacists and nurses monitor patients who are taking warfarin, sold as Coumadin, over several clinic visits. They test how fast the blood clots and adjust the dose accordingly: Too low a dose will not prevent dangerous blood clots and blood flow to the heart, brain or other areas of the body could be inadvertently blocked. Too high a dose could lead to dangerous internal bleeding.

Patients have the option of tracking their own blood response at home, using blood analyzers known as international normalized ratio (INR) monitors. Patients do a finger stick, apply a small amount of blood to a test strip and feed the strip into the device. The procedure resembles the one used by people with diabetes to check their blood sugar.

Patients can then call in the results to their provider and get advice on dose adjustments without coming to the clinic. In some cases, they can even set the proper dose of warfarin on their own.

The authors of the V.A. study expected home monitoring to work better than clinic monitoring, partly because self-testing can be done at home more frequently — weekly, compared with the typical monthly schedule of the best clinic-based monitoring. As a result, off-target INR values can be adjusted more regularly and more quickly.

However, the VA study found little difference between weekly self-testing and monthly testing by clinic-based care teams in the measured outcomes, which are strokes, major bleeding incidents and death.

The study did find, though, that self-testing at home may offer advantages in other areas: It moderately boosted patients’ satisfaction with the medication and slightly increased the length of time they were in the appropriate dose range.

Study co-leaders were Dr. David Matchar, M.D., an internist with the Durham, N.C., VA Medical Center, and Dr. Alan Jacobson, M.D., a cardiologist and researcher with VA and Loma Linda, Calif., University School of Medicine. They said the main message of the study is that patients who are systematically monitored — no matter by what means — are likely to have good outcomes.

The Department of Veterans Affairs (VA) has begun distributing disability benefits to Vietnam Veterans who qualify for compensation under recently liberalized rules for Agent Orange exposure.”

Up to 200,000 Vietnam Veterans are potentially eligible to receive VA disability compensation for medical conditions recently associated with Agent Orange. The expansion of coverage involves B-cell (or hairy-cell) leukemia, Parkinson’s disease and ischemic heart disease.

Send letters to Sgt. Shaft, c/o John Fales, P.O. Box 65900, Washington, D.C. 20035-5900; fax 301/622-3330, call 202/257-5446 or e-mail sgtshaft@bavf.org.

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