The Veterans Choice Program

The Veteran Choice Program allows veterans who have an excessive waiting period at the VA Med Clinic to go to their own health care provider in the community for services. The eligibility criteria for the Choice Program includes enrollment in the VA health care system, and:

  • Live more than 40 miles driving distance from the nearest VA medical facility with a full time primary care physician
  • Have to wait more than 30 days for an appointment
  • Face an unusual or excessive burden traveling to the closest VA medical facility based on a geographic challenge, environmental factor, medical condition, or other specific clinical decision
  • Call the VCP Call Center at 866-606-8198 to verify eligibility and set up an appointment

The Choice Program falls under the VHA Office of Community Care.



One of the most interesting things I find with PTSD is there are so many different symptoms or ways it affects us; hypervigilance, sleeplessness, isolation, flashbacks, and on and on. Avoidance is one of those symptoms that we may indulge in without even realizing we are doing so.

Excessive sleeping is a form of avoidance, and there are times I find myself using it as a coping mechanism. If I am so tired I can’t participate in activities I probably should be involved in, it becomes a good excuse to not take part. Excessive sleeping can look like depression too as it can also be a driving force in that way.

Avoidance prevents us from engaging in life, and that is not healthy. We need challenge in our lives and we need interaction with other people.   Avoidance prevents that. Sometimes the challenge becomes forcing ourselves to participate in events in our lives so we don’t indulge in avoidance.

Staying On Top Financially

Whatever stressors we’re dealing with, financial troubles only make things worse. Given that we all need to be able to handle our basic finances, I’m amazed that more attention isn’t given that topic while we’re young. Good financial training should be part of everyone’s basic schooling…or at least, I think that would be an excellent beginning.

When you’re trying to fight your way out of financial crisis, one of the best pieces of advice I can give is write things down! Start with listing what your sources of income are each month. You need to know what you’ve got to work with in order to decide where it needs to go.

Next, write down where your money goes. Are you paying bills? Are you spending money without paying attention to what you’re buying? By tracking your spending, you’ll know just where your money is going.

Prioritize your bills. Know when they are due, what the minimum payment is, and pay them first before you fritter money away on things that are wants rather than needs. Do you need to look for ways to earn a bit more money, or to sell items you no longer need? Can you cut costs by canceling memberships or services you don’t really require? Believe me, it’s worth doing without if it keeps the creditors off your back!

If you have to pay your bills over the course of the month, consider the order you need to pay them in. Some bills are more important than others. For example, if you don’t pay your rent or mortgage, you may get evicted making it harder to find alternate housing.

If you need help developing a plan for paying your debts, call the National Foundation for Credit Counseling at 800-388-2227.


PTSD and Avoidance

Avoidance is often one of the symptoms of PTSD. With avoidance, we do whatever we can to avoid thinking about or feeling emotions concerning the stressful events we have experienced. When avoidance is extreme, or when it is our primary coping mechanism, it can interfere with recovery and healing.

Emotional avoidance occurs when you try to avoid thoughts or feelings connected to a traumatic event. For example, your thoughts are racing about something traumatic that happened and you decide, “I’m just not going to think about that now.” While we may go to great lengths to avoid thinking about the event, it is often necessary in order for us to process it and move on.

Behavioral avoidance occurs when you work to avoid reminders of the trauma.  An example of this would be avoiding places where you may hear something that reminds you of what happened.

While not all avoidance is bad, it becomes a problem when it is your primary way of dealing with trauma. Therapy can help you learn to deal with your thoughts and feelings without becoming overwhelmed by them or resorting to excessive avoidance.



I have always found hypervigilance to be one of the more frustrating aspects of having PTSD. It means being over-active in observing everyone and everything around you in an attempt to keep yourself safe. Hypervigilance uses a lot of energy and can leave you feeling chronically exhausted and overwhelmed. For me, it meant each time I entered a room I unconsciously evaluated each person there as to the amount of risk I felt they posed to my safety. I monitored everyone, tracking them as they moved throughout the room. I felt moderately safe only if I sat with my back to the wall so no one could approach me without my knowledge. I hated going out anywhere as it took so much energy to keep track of everything.

It has taken me many years to “reset” my observation button! I believe going to college forced me to come to terms with the fact that I could never really keep myself totally safe by monitoring everyone. It was just not possible. I am happy to say that over the years, it has become easier for me to enter a room and not feel like I have to control it. I am much more comfortable now enjoying the other people there without feeling like they are a threat. I can go out and have a good time where others are present, and although I will probably never like being in a large crowd, I am comfortable enough to enjoy going to the movies on occasion or to a popular restaurant.

PTSD may have caused me to make some changes in my life, but I no longer feel I am a slave to the disorder. I can do things I never dreamed I would be able to do when I was younger, and I can find contentment even in the presence of others.


Post-Traumatic Stress Disorder (PTSD) and Service Dogs

According to the PTSD Consultation Program, estimates indicate that approximately 3.7 million of the 22 million Veterans in the United States have PTSD. Between 11 – 20% of those who served in Operations Iraqi Freedom and Enduring Freedom have PTSD. That’s a lot of people suffering! While there are many ways to treat PTSD, having a service dog may be one of the most pleasurable.

Owning any dog may lift your mood and help you when you are feeling stressed. Service dogs are trained to respond to a specific symptom though; they are not comfort animals. While the VA’s position is that there is not enough research yet to know if service dogs can really help treat PTSD, there are still benefits to be had by owning one.

Having a dog to do things with can make you feel more confident and comfortable. Service dogs can be trained to go into a building to scan it for danger before you enter. They can also be trained to block others from getting too close to you, to wake you from night terrors, to pick things up that you have dropped, or to help you balance when walking up or down stairs. They may even be trained to protect you if you are having a seizure.

If you are thinking about getting a Service Dog, consider that you will have to care for the animal, feed it, provide veterinarian services and do all the things that come with owning an animal. In addition, your dog will have to be trained to meet a specific need, and it will have to have extensive obedience training if you plan to take it on outings with you.

Currently, the VA does not provide service dogs for physical or mental health conditions. The VA does provide veterinary care for service dogs that are deemed medically necessary for the rehabilitation or restorative care of Veterans with permanent physical impairments.


The Nightmare of PTSD

Many people suffering from PTSD (Post-Traumatic Stress Disorder) have nightmares as one of their symptoms. These are not just your average run-of-the-mill nightmares, but instead are often violent, repetitive and rob the individual of much needed sleep night after night. Oftentimes, the person’s spouse is afraid of being the one to waken the individual for fear of not being recognized and of being attacked. One way of the ways of responding to nightmares is by use of a service dog.

It can sound, at first, like it is an impossibility to think about using a service dog to stop nightmares, but a well-trained dog is actually quite successful at it. The training is not particularly difficult; it starts with teaching the dog to “touch” on command. Once he has mastered “touch,” he learns that he is to respond to this command when he sees his master tossing, turning and crying out while in bed.

The dog, of course, must also learn proper manners as he will be an ambassador for all service dogs when he is out in public. That means he must learn to sit quietly when told, lie out of the way when in crowded places, and go wherever his master goes all the while behaving himself. It takes some time to teach a dog this, but it is certainly possible.

If you suffer from nightmares related to PTSD, you may want to consider using a service animal. Waking to a warm, gentle nudge and finding your best furry friend has roused you can be preferable to having your spouse wake you in absolute terror for fear he or she will be mistaken for the enemy.