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HIS WAR AFTER THE WAR -- For about a year, he has relied

on a feisty mother, some congressional clout and his own

determination to receive the care he says he deserves.

 

 

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His war after the war

By Mike McAndrew
Staff writer

Jeff Guerin can’t walk to his refrigerator without feeling shooting pain. He rarely leaves his house because his ankle hurts too much. He swallows up to 16 pain pills a day.

A roadside explosion in 2004 in Afghanistan left Guerin, 24, an Army medic from Marcellus, blind with broken bones in both legs.

Despite many operations, Guerin’s left ankle didn’t mend, and the bone and cartilage are dead. He’s resisting his doctor’s recommendation to amputate the lower leg.

Unable to serve his country anymore, Guerin is now waging war with the nation’s veterans medical system.

Guerin contends he received almost no physical therapy during his 1½ years as a patient at Walter Reed Army Medical Center, in Washington, D.C., or during 16 months of outpatient care at the VA Medical Center in Syracuse.

He says his ankle might have healed had he received the therapy.

Beyond that, he describes the Department of Veterans Affairs as an $80 billion bureaucracy that is impersonal, complicated and pinches pennies. For about a year, he has relied on a feisty mother, some congressional clout and his own determination to receive the care he says he deserves.

In October, the VA arranged for Guerin to undergo ankle surgery at Strong Memorial Hospital, in Rochester. When Guerin was about to be discharged, a hospital official told him that his Defense Department medical insurance refused to pay for a $600 four-wheeled walker he used.

In frustration, on his way out of the hospital, he stole one.

This year, the VA denied Guerin mileage reimbursement for his VA hospital visits because he doesn’t live more than 27 miles away. No matter that Guerin’s parents drive 77 miles round-trip to take him. The VA pays patients 11 cents a mile; the agency reimburses its employees up to 48 cents a mile. The VA offered to arrange free transportation for Guerin but he declined because he thought it would increase his travel time, and his pain.

The Rochester hospital has been sending him a $10,000 bill because he used the wrong insurance card. Guerin said he’s trying to get reimbursed for hundreds of dollars in other bills he’s paid because the VA didn’t explain the insurance system to him.

This summer, Guerin’s mother, Colleen, asked for a copy of a letter the Syracuse VA director wrote to Rep. James Walsh, R-Onondaga, detailing its care of Guerin.

Though Guerin had given the hospital written permission to share his medical records with his mother, a Syracuse VA official told her she had to file a Freedom of Information Act request.

Guerin signed a release authorizing Syracuse VA officials to talk to a Post-Standard reporter about his care, but Director James Cody and other VA officials declined.

Complicated system

Since the Sept. 11, 2001, terrorist attacks, 28,000 American service members have been wounded in Iraq and Afghanistan. More than 3,000 of them are seriously injured.

In July, a presidential commission recommended "fundamental changes" to simplify the military’s convoluted health-care bureaucracy and to provide better care and benefits. It suggested the military assign "recovery coordinators" to help seriously injured service members navigate the system.

As it stands, a volunteer from the Disabled American Veterans is assigned to help Guerin. Guerin’s service officer is stationed in Buffalo. Guerin said they have never talked.

There are two DAV volunteers to serve wounded soldiers from Syracuse to Buffalo.

"This isn’t happening to just Jeff. There’s more wounded veterans coming," said Colleen Guerin. "What you’re going to have is a whole bunch of people trained to kill who are put into a medical system that’s so aggravating.

"The public just wants to ignore the war. But the whole population better start caring, because there’s a whole lot more injured people coming back," she said.

He promised to come home

Colleen Guerin reluctantly signed paperwork allowing her son to enlist in the Army when he was a 17-year-old Marcellus High School senior.

Jeff grew up in a middle-class family, the son of an Onondaga County drainage and sanitation worker and a real estate agent. He played basketball as a youth. During his final two years of high school, he worked at a pet store in Liverpool.

Guerin said he wasn’t sure what he wanted to study in college, so he signed up in 2000 for four years of Army active duty and four years of reserves.

Just months before the Sept. 11, 2001, terrorist attacks, Guerin completed his Army medic training.

In May 2004, as Guerin prepared to go to Afghanistan, he visited Marcellus on leave. He spent his final night at a tavern there, playing pool with his parents and girlfriend, Jennifer Toteda.

In the bar, Ed Guerin told Jeff that if he survived, he would give his son his restored 1970 green Dodge Challenger.

Jeff promised he’d come home alive.

'I heard the sound first’

In Afghanistan, Guerin supervised three other medics in a 60-soldier company. He kept the medics stocked with supplies and treated American soldiers for colds and dehydration.

He said his company did a lot of show-of-force patrols but had few casualties. Guerin carried a sidearm but never shot at anyone.

In October 2004, Taliban forces ambushed soldiers in Guerin’s company. A rocket-propelled grenade seriously injured an officer.

Four days later, his unit had to escort a convoy of supply trucks over the same bridge where the ambush had occurred. Guerin joined four soldiers in a Humvee at the rear. Two helicopters buzzed overhead.

"About 400 meters after we passed the danger area, I heard the sound first, and then everything went black," said Sgt. First Class Helbert Izquierdo, who was sitting next to Guerin. "I was thrown from the vehicle, and the gunner was, too. When I came to, I heard my gunner screaming like I have never heard anyone before."

A remotely detonated IED — improvised explosive device — had knocked Guerin’s Humvee upside down.

The driver and front-seat passenger — Spc. Kyle Ka Eo Fernandez, 26, of Waipahu, Hawaii, and Staff Sgt. Brian Hobbs, 28, of Mesa, Ariz. — died. The gunner — Spc. Joey Banegas, of La Cruces, Texas — lost his right leg. Izquierdo’s femur — the thigh bone — was broken. Guerin was barely conscious inside the burning Humvee.

Later that day, an Army official called Guerin’s parents and put Jeff on the phone.

"I said, ‘Jeffrey, oh my God! Are you OK?’ He sounded groggyish," his mother said. "You could tell he was injured. But he said, ‘Mom, I’m good. I’m telling you, I’m good. I just got a couple bumps or bruises. I’m fine. I’m fine.’

Waking up in Germany

Colleen and Ed Guerin immediately flew to Jeff’s bedside in Germany. They found him in a civilian hospital in Heidelberg, surrounded by workers who did not speak English.

Shrapnel had pierced both of Guerin’s eyes. He was blind.

During his parents’ first night there, Guerin heard hospital workers speaking a foreign language and, thinking he was captured, he "freaked out," Colleen Guerin said.

"Why don’t you just give me a gun, and I can get it over with now?" she recalls him saying.

He ripped the IVs and eye patches off. He tried to stand.

Colleen Guerin said she began demanding that her son be moved to an American military hospital. When no one listened to her, she began dropping F-bombs.

"They understood that," she said.

The next day, Jeff was transferred to a U.S. Army hospital in Germany.

Colleen Guerin jokingly calls herself the "lunatic mother." But she said the government’s care for her son during the last three years forced her to become aggressive.

On Aug. 7 this year, she gave Syracuse VA Medical Center Director James Cody a warning: "I will hold the government responsible if my son loses his leg."

Waiting for therapy

When Guerin was flown back to the United States, he was admitted to Walter Reed and stayed there for nearly 1½ years.

Walsh visited Guerin at Walter Reed within days of his arrival and promised to help. Guerin also met President Bush and the first lady. A few months later, Walsh arranged for Guerin to be his guest at Bush’s second-term inauguration.

Guerin said doctors operated on his eyes and legs several times during his first six months. Doctors removed the lenses from his eyes. An 18-inch rod was put inside his lower right leg to fix broken bones there.

With his left eye, Guerin can see only shadows. Without special glasses, he is completely blind. With glasses, the sight in his right eye improves to 20/70.

For nearly a year, Guerin said, he lay in bed in a dark room, waiting for an Army administrative board to rule that he was temporarily disabled. He would go weeks without seeing a doctor, he said.

At Walter Reed, he said, he was never offered aquatherapy — physical therapy in a pool that enables patients to exercise without putting weight on injured joints.

Guerin said he didn’t receive physical therapy for his ankle until late February, almost a year after he left Walter Reed and became an outpatient at the VA Medical Center in Syracuse.

Dr. Adolph Flemister, Guerin’s ankle surgeon in Rochester, said it appears from Guerin’s limited medical records from Walter Reed that physicians there tried hard to fix Guerin’s ankle. Flemister said he saw no evidence in the records that Guerin had received physical therapy.

That therapy might have helped Guerin’s ankle heal, Flemister said. But the injury is so severe, Guerin might still be in tremendous pain and facing amputation even if he had received therapy, the doctor said.

In October, to try to reduce Guerin’s pain, Flemister fused the bones in Guerin’s ankle and cut another bone in half to straighten the foot. Blood no longer circulates through the joint, however, and the ankle bone and cartilage are dead. Guerin cannot turn his ankle side to side and can barely move it up and down.

Flemister said he can do another operation to immobilize Guerin’s ankle and make it like a peg leg. That might reduce Guerin’s pain.

If that doesn’t work, Guerin’s best option is amputation, Flemister said.

"Amputation would get completely rid of the pain," he said. "If it was my leg, I’d probably have amputation done."

At Guerin’s request, the VA in February sent a physical therapist to his home. The therapist came four times. Guerin couldn’t put any weight on his ankle. The therapist told him he couldn’t do anything else for him, and the sessions ended, Guerin said.

Guerin asks for a pool

After the doctor recommended amputation, Guerin began asking the VA to pay for an indoor aquatic therapy pool at his home in Clay.

Therapy pools cost $20,000 to $60,000 to install.

Aquatherapy would improve Guerin’s overall health, and it might help him avoid amputation, Flemister said.

Twice this summer, VA officials in Washington denied Guerin’s request. VA officials suggested Guerin seek the therapy at a clinic three miles from his home.

"Just the act of putting my boot on, getting into the car and going to where I’m going is extremely painful. It swells up and hurts more," Guerin said.

Late last month, at the VA’s urging, Guerin began receiving aquatherapy at a pool at the Central New York Physical Therapy & Aquatic Center, in North Syracuse. But he said he is in too much pain to go there daily.

On Aug. 9 — two days after Walsh and Guerin met with Syracuse VA director Cody and a day after The Post-Standard began asking Cody questions about Guerin — VA officials in Washington agreed to buy Guerin the pool.

Guerin is believed to be the first veteran in the nation to get one from the VA, a VA spokesman said.

"It shouldn’t have taken this long," Guerin said. "If you send someone overseas, and I don’t blame anyone but if there’s something you need in recovery, it should be done."

Cody said he personally lobbied VA officials to pay for Guerin’s pool. The VA eventually approved it because Guerin supplied additional letters documenting his need, not because of outside pressure, Cody said.

Therapist Sergio Zappala, who runs the clinic in North Syracuse, sent the VA a letter.

"I think (the pool) is a small price to pay for someone who almost died risking his life for our country," Zappala wrote.

'It breaks your heart’

The Syracuse VA Medical Center — which serves veterans from 13 counties — had 40,000 inpatients last year and more than 374,000 outpatient visits.

In an April survey, 85 percent of the facility’s outpatients polled and 88 percent of inpatients polled said they were very satisfied with the service they received, said Gordon Sclar, the center’s spokesman.

Two Central New York soldiers — Justin Callahan, of Syracuse, whose left leg was amputated after he stepped on a mine in Afghanistan; and Jonathon Madonna, of Jordan, who fractured vertebrae and his left leg in Iraq — said they received good medical care and physical therapy at Walter Reed and the Syracuse VA Medical Center.

"Across the board, our veterans are extremely well served," said Walsh, who as the former chair of a House subcommittee helped steer billions of dollars per year to veterans health care facilities.

The congressman said he thinks the VA staff has "tried their best to get Jeff headed in the right direction, but it’s a very complicated case."

"I love this kid," Walsh said. "It breaks your heart to see what he’s going through."

Pills and a cloudy future

While he’s unhappy with his medical care, Guerin recognizes the government is compensating him for his injuries.

He received a $100,000 settlement from an Army insurance policy. He spent most of that on a home, furniture and a car for his fiancee, to replace one she wrecked while visiting him at Walter Reed.

The VA pays him $3,154 tax-free per month in disability compensation. Guerin also receives about $1,000 per month in Social Security disability.

Because he is in constant pain, Guerin said, he spends most of his days lying with his three dogs in a recliner, playing video games and watching movies on a 65-inch projection TV.

He takes up to 12 oxycodone and four morphine pills per day and worries he’ll become an addict.

He and his fiancee plan to get married soon. Guerin said he figures he will stay home and take care of the children they want to have. He doesn’t think he’ll ever be able to work.

Guerin kept the promise he made to his dad in the bar three years ago. He came home alive. But it didn’t work out the way they planned.

His father sold the 1970 Dodge Challenger that was supposed to be his reward and gave him the cash.

Driving a car is one more thing Guerin’s learning to live without.

Mike McAndrew can be reached at mmcandrew@syracuse.com  or 470-3016.

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Larry Scott  --