thedrifter
09-03-08, 08:02 AM
Injured veteran wins toughest battle yet - for power wheelchair
By MARK MUCKENFUSS
The Press-Enterprise
Matt Tringali wonders why it took five years for doctors at the Veterans Affairs Medical Center in Loma Linda to agree with him.
Tringali, 48, was in the Marines when he was injured in 1976 in Hawaii in a noncombat-related incident. It left him with a back injury. He'd undergone six surgeries between 1988 and 2002, the year he tripped on a sprinkler at his home, fell and could not get up, he said.
Since that time, Tringali said he has struggled with mobility and severe pain. On more than one occasion, he says, he has been reduced to crawling on his hands and knees through the VA hospital. But his greatest struggle, he said, has been convincing the doctors there that he needs a power wheelchair.
"Every time I go, I think, 'How could they turn me down?' " he said. "But they do. I don't know how many more things I could have wrong with me. I think, 'How could it get any worse?' But it does."
Last week, Tringali got the call he'd been waiting for.
Lying on special elevated cushions on the living room couch in his San Bernardino home, Tringali couldn't help smiling as he spoke with a VA official on the phone.
"She's going to give me the power chair?" he said. "Beautiful, beautiful. Thank you very much. God bless you."
'I Played the Game'
It's been a long painful journey, said Tringali. Although he has a manual wheelchair, he said damage to his arms and shoulders has left him unable to operate it himself. Walking with a cane has further injured his arms, he said. He has pain in his shoulders, numbness in his hands.
Tringali spent five years in practice in California as a chiropractor. He says he believes much of the damage to his arms and shoulders could have been avoided had the VA given him a power wheelchair when he first asked for it.
Hospital spokeswoman Annie Tuttle said that Tringali's condition did not warrant the use of a power wheelchair until now. Part of the delay, she said, was Tringali's refusal to cooperate with hospital officials.
"Veterans would often like a power chair," Tuttle said, "but it's not always the best thing for them. He was evaluated and there was no medical need," she said, referring to Tringali's initial request several years ago.
Sparring With Doctors
More recently, Tuttle said, doctors had told Tringali that he needed to have his shoulders evaluated to determine the need for a power wheelchair.
"He's basically saying, 'My shoulders won't allow me to use the manual wheelchair,' " she said. "He had no workup on his shoulders. They said, 'You need to get worked up on that.' (But) he declined."
Tringali said he's been trying for more than a year to get doctors at the hospital to evaluate his shoulders.
Despite complaining to his orthopedic doctor, he said, "he wasn't even going to deal with it. He told me he was only going to treat me for my back. He just wrote prescriptions and sent me on my way."
Tringali admits he can be headstrong.
"Until this last year, I played the game," he said. But after four years of working with the system and twice being denied a power wheelchair, he became combative. When his pain forced him to his hands and knees at the VA hospital, he refused help from the staff.
"They'd say, 'Let me get you a chair,' " he said, "and I'd say, 'No, not unless you're going to push me around at home and at the mall.' If I don't qualify for a power chair, then this is how I'm supposed to be."
Tringali's wife, Angie, 32, said she has watched her husband's quality of life deteriorate over the past several years.
"He doesn't go anywhere any more," she said. "I'm seeing him depressed all the time. He doesn't feel like he can do anything."
Other than going to his doctor appointments and to church, Tringali said he has essentially been housebound. He spends the majority of his days in bed because of pain, he said. Doctors, he said, have had him on morphine for the past five years.
Angie is hoping that having a power wheelchair will help her husband.
"I think it would improve a lot, his self-esteem," she said. "He'd be able to do little things with us. My son plays Little League. He's had like seven games. Matt's only been able to go to one and he couldn't stay for the entire game."
Kim Starr is the pastor of Crossroads Christian Center in Rialto, a church Tringali has attended for the past six months. Starr said he usually sees Tringali come into church hunched over, walking with a cane.
"I have seen him come in quite in pain," Starr said. "From my perspective, I do have questions as to why he (hasn't had) the equipment necessary to facilitate his movement."
Tringali said things only began to move forward when a patient advocate at the hospital suggested he call the VA headquarters in Washington D.C. to request a second opinion. Only then, he said, did he get a referral to the VA hospital in Long Beach.
Doctors there did not approve a power wheelchair for him either. But they requested an MRI on his shoulders.
Tringali said the doctors told him "they would re-evaluate it once I got the MRI."
Loma Linda took at look at the scan results first and approved Tringali for the power wheelchair.
Despite the fact that the hospital was contacted by Rep. Joe Baca's office about Tringali's case the same week his chair was approved, spokeswoman Tuttle said there was no connection.
Tuttle said the VA is not stingy with issuing power wheelchairs. Last year, she said, the Loma Linda facility spent $428,000 on power wheelchairs. Power wheelchairs cost the hospital $1,665 each, but there are associated costs that run much higher. Wheelchair lifts for vehicles are $4,361 and ramps for home entryways average $2,300 apiece.
VA doctors, Tuttle said, are often reluctant to provide chairs to patients because they fear it may cause them to become sedentary, leading to other kinds of health problems.
Tringali said he expects his own activity to be greatly increased with a power wheelchair and wishes the decision had been made years ago before his arms and shoulders got so bad.
"They're a little too late now," he said, "but I qualify."
Reach Mark Muckenfuss at 951-368-9595 or mmuckenfuss@PE.com
Ellie
By MARK MUCKENFUSS
The Press-Enterprise
Matt Tringali wonders why it took five years for doctors at the Veterans Affairs Medical Center in Loma Linda to agree with him.
Tringali, 48, was in the Marines when he was injured in 1976 in Hawaii in a noncombat-related incident. It left him with a back injury. He'd undergone six surgeries between 1988 and 2002, the year he tripped on a sprinkler at his home, fell and could not get up, he said.
Since that time, Tringali said he has struggled with mobility and severe pain. On more than one occasion, he says, he has been reduced to crawling on his hands and knees through the VA hospital. But his greatest struggle, he said, has been convincing the doctors there that he needs a power wheelchair.
"Every time I go, I think, 'How could they turn me down?' " he said. "But they do. I don't know how many more things I could have wrong with me. I think, 'How could it get any worse?' But it does."
Last week, Tringali got the call he'd been waiting for.
Lying on special elevated cushions on the living room couch in his San Bernardino home, Tringali couldn't help smiling as he spoke with a VA official on the phone.
"She's going to give me the power chair?" he said. "Beautiful, beautiful. Thank you very much. God bless you."
'I Played the Game'
It's been a long painful journey, said Tringali. Although he has a manual wheelchair, he said damage to his arms and shoulders has left him unable to operate it himself. Walking with a cane has further injured his arms, he said. He has pain in his shoulders, numbness in his hands.
Tringali spent five years in practice in California as a chiropractor. He says he believes much of the damage to his arms and shoulders could have been avoided had the VA given him a power wheelchair when he first asked for it.
Hospital spokeswoman Annie Tuttle said that Tringali's condition did not warrant the use of a power wheelchair until now. Part of the delay, she said, was Tringali's refusal to cooperate with hospital officials.
"Veterans would often like a power chair," Tuttle said, "but it's not always the best thing for them. He was evaluated and there was no medical need," she said, referring to Tringali's initial request several years ago.
Sparring With Doctors
More recently, Tuttle said, doctors had told Tringali that he needed to have his shoulders evaluated to determine the need for a power wheelchair.
"He's basically saying, 'My shoulders won't allow me to use the manual wheelchair,' " she said. "He had no workup on his shoulders. They said, 'You need to get worked up on that.' (But) he declined."
Tringali said he's been trying for more than a year to get doctors at the hospital to evaluate his shoulders.
Despite complaining to his orthopedic doctor, he said, "he wasn't even going to deal with it. He told me he was only going to treat me for my back. He just wrote prescriptions and sent me on my way."
Tringali admits he can be headstrong.
"Until this last year, I played the game," he said. But after four years of working with the system and twice being denied a power wheelchair, he became combative. When his pain forced him to his hands and knees at the VA hospital, he refused help from the staff.
"They'd say, 'Let me get you a chair,' " he said, "and I'd say, 'No, not unless you're going to push me around at home and at the mall.' If I don't qualify for a power chair, then this is how I'm supposed to be."
Tringali's wife, Angie, 32, said she has watched her husband's quality of life deteriorate over the past several years.
"He doesn't go anywhere any more," she said. "I'm seeing him depressed all the time. He doesn't feel like he can do anything."
Other than going to his doctor appointments and to church, Tringali said he has essentially been housebound. He spends the majority of his days in bed because of pain, he said. Doctors, he said, have had him on morphine for the past five years.
Angie is hoping that having a power wheelchair will help her husband.
"I think it would improve a lot, his self-esteem," she said. "He'd be able to do little things with us. My son plays Little League. He's had like seven games. Matt's only been able to go to one and he couldn't stay for the entire game."
Kim Starr is the pastor of Crossroads Christian Center in Rialto, a church Tringali has attended for the past six months. Starr said he usually sees Tringali come into church hunched over, walking with a cane.
"I have seen him come in quite in pain," Starr said. "From my perspective, I do have questions as to why he (hasn't had) the equipment necessary to facilitate his movement."
Tringali said things only began to move forward when a patient advocate at the hospital suggested he call the VA headquarters in Washington D.C. to request a second opinion. Only then, he said, did he get a referral to the VA hospital in Long Beach.
Doctors there did not approve a power wheelchair for him either. But they requested an MRI on his shoulders.
Tringali said the doctors told him "they would re-evaluate it once I got the MRI."
Loma Linda took at look at the scan results first and approved Tringali for the power wheelchair.
Despite the fact that the hospital was contacted by Rep. Joe Baca's office about Tringali's case the same week his chair was approved, spokeswoman Tuttle said there was no connection.
Tuttle said the VA is not stingy with issuing power wheelchairs. Last year, she said, the Loma Linda facility spent $428,000 on power wheelchairs. Power wheelchairs cost the hospital $1,665 each, but there are associated costs that run much higher. Wheelchair lifts for vehicles are $4,361 and ramps for home entryways average $2,300 apiece.
VA doctors, Tuttle said, are often reluctant to provide chairs to patients because they fear it may cause them to become sedentary, leading to other kinds of health problems.
Tringali said he expects his own activity to be greatly increased with a power wheelchair and wishes the decision had been made years ago before his arms and shoulders got so bad.
"They're a little too late now," he said, "but I qualify."
Reach Mark Muckenfuss at 951-368-9595 or mmuckenfuss@PE.com
Ellie