Complementary and Lifestyle Management Choices

Many Veterans we talked with manage some of their GWI symptoms through complementary and lifestyle management choices. Over the years, Veterans with GWI tried behavioral approaches (e.g., physical therapy), vitamins and supplements, and alternative approaches (e.g., acupuncture) to manage their GWI symptoms and improve their overall health and wellness. Here, we highlight some of the Veterans' experiences trying complementary and alternative approaches and integrating them with medication management.

Strategies for Managing Pain

Interviewees used a wide range of non-pharmacological or complementary strategies to manage day-to-day pain and improve function. Strategies Veterans described as helpful for pain included acupuncture, moderate physical activity, chiropractors, physical therapy, massage, using a hot tub, and practicing mindfulness. “Alan” found some relief with Botox injections for headaches and a TENS unit for lower back pain. Peter found massage helpful and advocated for VA to cover these services.

 

The hot tub is Debra's treatment of choice for her fibromyalgia.

The hot tub is Debra's treatment of choice for her fibromyalgia.

Gender: Female
Birthday: November 1966
Racial or Ethnic Identification: Caucasian
Branch of Military: Army
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You know what works for fibromyalgia for me, is the hot tub. I think that’s what we were talking about, is the hot tub. That helps with my fibromyalgia way more than any medication I’ve ever taken. And on my bad days, I will go straight from the bed, to the hot tub. And I’ll sit in there for an hour, in you know 100 degrees. And in the cold, cold winter I’ll use the sauna, do the same thing. And those things help better to, maybe it’s just to get the circulation going in the muscles or something. But, I can barely climb in, but I can climb out. So, that’s what, you know and the pain doesn’t, my muscles get sore but they don’t get painful. And that’s what I’m trying to ignore, or, trying to avoid.

 

Floating in water, using a hot tub, and acupuncture help Gaylon’s achiness.

Floating in water, using a hot tub, and acupuncture help Gaylon’s achiness.

Gender: Male
Birthday: October 1953
Racial or Ethnic Identification: Unknown
Branch of Military: Army
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And they give me a pill for the achiness but it doesn’t really work very good. I’ve been doing acupuncture and that’s been helping me, you know. But it just seems like you ache and there’s different spots on your body and you just barely touch them and it’s like pain. And I’ve got a whole bunch of them all over my body where they just, you know, just like a constant ache. Tylenol helps a little bit. But they give me an NSAID and stuff for, you know, meloxicam but it doesn’t seem like it helps that much. And swimming helps, getting in water, laying around like a hot tub, stuff like that. But I need to do that more, but that seems to help a bit, but that’s about it.

 

Peter wishes the VA would pay for what works for him: massage therapy.

Peter wishes the VA would pay for what works for him: massage therapy.

Gender: Male
Birthday: November 1959
Racial or Ethnic Identification: Lebanese
Branch of Military: Army
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One of the things that, one of the best treatments that I could get, but I can’t afford it and the VA won't pay for it because they don’t recognize it as valid, is massage therapy. That's probably the number one pain reliever when my muscles are going crazy, which is all the time. I do lots and lots and lots of heat and cold. Lots of, almost every night I start a cold-water bath on my feet. Little thing that warms up really slowly, so by the time it finally gets warm, my water bath has gone from cold to warm, and it feels really good. Doesn’t really seem to really help the inflammation, but it's sure nice to do. I can’t think of any other treatments offhand. I just went through a tai chi program. That was pretty good. That blew me away. I was real skeptical when I went in. That's pretty neat stuff. Mentally, I've tried every CBT and acceptance and commitment therapy that you can name off. I went through a really good class here. The therapist is no longer here. I can’t remember his name. It was like a 16-week program for dealing with chronic pain, and it absolutely was probably the single best therapy that I've encountered for dealing with chronic pain. And it basically was an acceptance kind of thing, but it wasn't here's some papers, and I’m going to lecture you for 20 minutes, and you go home and feel no pain. We actually worked at it for three months. It was, and there were other Veterans there that were in chronic pain. We opened up to each other, and it was like, okay, I’m not crazy. It was just fantastic. The biggest thing that has helped me with that.

 

Infrared sauna and lights, as well as nutrition and TENS units help Andrew.

Infrared sauna and lights, as well as nutrition and TENS units help Andrew.

Gender: Male
Birthday: December 1963
Racial or Ethnic Identification: Caucasian
Branch of Military: Army
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Andrew: That’s my hobby, so I will stay up and read about the latest nutrition coming out. I have attended all kinds of conferences, I’ve gone to Vegas on stuff, so I’ve stayed on top of what’s cutting edge. You’re going to think I’m kinda nuts but I also stay on top of the vet. I’ve seen where veterinarian science will actually out pace human science. So I had an infrared light that I bought at a vet store, that had the full spectrum infrared, I spent $700 on one of those for the pain because it would deep. Now you can buy them for humans, but you could buy them from the vet store way before that. You know, and I had my own tens unit, I’ve had my… for the headaches, I’ve had the BioStim®. Where you put it on your head, I cant remember, but the low level electrical pulse, where you put it on different points and it helps with headaches and stuff like that? I’ve tried every known possible thing to try and get rid of headaches and body aches and pain in my body. I’m obsessed with it because it hurts so bad.

Interviewer: It does sound like it hurts at a very high level, very severe pain…

Andrew: I have my infrared sauna, I’ve had it for probably 10 or 15 years I’ve had one, that helps.

 

Robert has high hopes for physical therapy and chiropractic for his migraines.

Robert has high hopes for physical therapy and chiropractic for his migraines.

Gender: Male
Birthday: March 1961
Racial or Ethnic Identification: Caucasian
Branch of Military: Army
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And I also have physical therapy coming up and then every week I go to a chiropractor and so I’m trying to do what I can in order to try and get some more mobility and, hopefully, get some reprieve from my migraines, headaches. Because if I don’t, I don’t know what’s going to happen. I’ll just be sitting in my house because they’re just—I mean right now they’re dictating my life.

 

Jean describes her journey to find a naturopathic doctor.

Jean describes her journey to find a naturopathic doctor.

Gender: Female
Birthday: February 1958
Racial or Ethnic Identification: Caucasian
Branch of Military: Air Force
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Well, I wasn’t in the VA system yet in the mid '90s because I was still in the service. You could go to the flight doctor on base if you had problems, but if you did, they would ground you, and I didn't want to lose my job, so I didn't tell them anything about what was going on for the most part. As long as I was safe to do my job, I stayed out of the clinic on base. Now the heel spurs was a problem because that affected how I walked, so I went to, I actually had a regular civilian job for a little while, I think from '93 to '96, and I had insurance, so I went to a podiatrist or whatever, the people that look at feet. And they did the x-rays and showed the bone spurs, the heel spurs, and they tried, I don't remember what they tried. I know they did cortisone shots. None of it worked, and that's when I, between that and the other symptoms, that's when I started getting frustrated with regular MDs, and I decided to try to look for something else to help me because the pain was terrible. I just hurt every day, so I found a naturopathic doctor who did acupuncture and had him address the heel spurs. And when he was able to help me with that, then I went back at him with I've got all these symptoms. I was in the Gulf. I don't know what's wrong. Nobody, you know. I mean, you talk to the other, I would talk to other people that I flew with and see, and other people had symptoms too, but nobody was talking about it a whole lot because nobody wants to lose their job, you know. And nobody knew exactly what was going on. So, I had him address some of these other things, and he did some research, I guess, and he figured if we do some cleanses and try to detoxify my body that it would help, and it actually did help some. So, that was the mid '90s.

Dietary Changes to Improve Specific Symptoms and General Wellness

Several Veterans altered their diet to help. Roy opted for oatmeal to improve bowel function while others such as Peter noticed a more global improvement of symptoms such as pain and fatigue on a low glutamate diet. “Alan” tried a low cholesterol diet. 

 

A low glutamate diet, vitamins (including CoQ10), and Theracurmin have helped Peter’s symptoms.

A low glutamate diet, vitamins (including CoQ10), and Theracurmin have helped Peter’s symptoms.

Gender: Male
Birthday: November 1959
Racial or Ethnic Identification: Lebanese
Branch of Military: Army
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Well, some of the preventative kind of things. Taking CoQ10. Taking Theracurmin. Taking a vitamin regimen. A thing that I tried last March, which was somewhat beneficial, which I haven't been able to continue because of my gut problems, is a diet that was developed by a researcher at American University in Washington, D.C., that essentially eliminated glutamate because glutamate is a neuroactive substance, and that's the problem that is endemic. So I went through this diet program where I eliminated all processed foods. I eliminated certain types of other types of foods, basically eating a fresh diet, and that really helped. Some things that, like I had a three- or four-week period that the burning of my feet went away. Then I just couldn’t eat that way anymore because I can’t eat vegetables. It's horrible. And that's what I was, like, that was my main thing. I used to eat like a Mediterranean style. My mom was Lebanese. I grew up eating, meat was not the center of the meal. It was vegetables, grains, and that's the way I like to eat. Lots of vegetables, big salad, and a little piece of meat, and I’m happy. I can’t eat that way anymore, and I’m putting on weight, and I’m not happy with that at all.

 

Shawn tried elimination diets and nutrition education to ease his IBS symptoms.

Shawn tried elimination diets and nutrition education to ease his IBS symptoms.

Gender: Male
Birthday: September 1972
Racial or Ethnic Identification: Caucasian
Branch of Military: Air Force
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And he did some testing, stool samples and things like that, and they couldn’t find anything wrong. I then went back to the VA to address it, I don’t know how many years later, and first thing they said was you're probably lactose intolerant. Okay, so that's an easy fix. You reduce your lactose. Try to eliminate it wherever you can. And I did notice there were certain foods that really bothered me that were dairy, and other dairy foods didn’t seem to. And there were some workarounds you do. When I wanted to eat pizza, I discovered if I microwaved it, I was okay. If I didn’t, it make me sick. Makes you wonder about microwaves. But, so you do the workarounds and stuff, but then you realize that taking the pills to help offset those things, cutting your diet, I mean I did elimination diets of gluten, of red meat, of refined sugars, of carbs. You name it, I eliminate it for at least 30 days. Nothing was helping. So there were flare-ups, there were things that could help, but nothing eliminated it…Other stuff, there’s a nutrition class here offered at the VA in Roseburg that was 10 weeks or something like that, and I went to all but one of those. Missed one to go get him. I have studied nutrition. I’m coaching in college and little kids. I know this stuff, but it's nice to get refreshed, to be reminded or to learn that there's new tools, especially on our phones now to make it much easier to check out calories and the fat and the carbs and vitamins and nutrients and stuff. So, for me, it wasn’t like I was learning brand-new things, but, yeah, it prompted me to learn about more opportunities that the VA offers. And they do seem to be offering a lot of things for the whole wellness. I've tried acupuncture, the battlefield acupuncture. Did not work for me. The guy did tell me that they find that for nerve pain it doesn’t help very many people, but for muscular pain it does tend to.

Psychotherapy and Behavioral Programs for Mood, Pain, and Changes in Function

Several participants had tried psychotherapy to manage depressed mood, anger, anxiety and co-morbid PSTD. Others noted support groups had been helpful for managing chronic pain and challenges adapting to loss of function and changing identity. Some felt therapists who didn’t serve themselves did not understand their experiences and were thus not particularly helpful. While others, such as Roy, felt like therapy “saved” him. For more experiences with mental health conditions and treatment, click here.

 

Roy credits his therapist for saving him.

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Roy credits his therapist for saving him.

Gender: Male
Birthday: December 1963
Racial or Ethnic Identification: African American
Branch of Military: Army
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That’s when I met my therapist, she saved me. That lady saved me. She gave me a safe place to download my feeling, my emotions, and she saved me. She did. And I thank her for that.

 

Robert takes all the classes he can to feel better, emotionally.

Robert takes all the classes he can to feel better, emotionally.

Gender: Male
Birthday: March 1961
Racial or Ethnic Identification: Caucasian
Branch of Military: Army
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And that’s why I’m trying to do everything that they ask me to do here at the VA; go to different classes and do these different opportunities, you know, physical therapy and all these different classes. How to Heal Yourself and things like this because if I don’t do it, I won’t know what will help. And that’s what’s most important. And a lot of times I don’t even feel like getting out of my house. But when I do get out of my house it’s usually to come up to the VA for appointments, or maybe I have to go shopping for some food and that’s it. I don’t get out very often. And that’s the migraines have done to me. I’ve been put in depression. I’m on depression meds. I’m on sleep meds. There’s just so much and my body can only take so much.

 

Shannon uses all her resources and loves the VA classes.

Shannon uses all her resources and loves the VA classes.

Gender: Female
Birthday: December 1964
Racial or Ethnic Identification: Hispanic
Branch of Military: Army
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And I’m glad that I’ve got the resources available, you know? And there’ll always be these classes and things like that to go to, because I’ll start one class, which will be an eight-week class, on a Tuesday. But then there’s two other classes on that same Tuesday that I’d like to take too. So I do my eight weeks and then I go to the next one and I do my six weeks or whatever that one is and then. So there’s always something that’s new that I can keep doing to improve, you know, my quality of life. And you know being single, a single parent of course I’m looking forward to my daughter leaving, you know it is very, it is more difficult being single than it would be to have family, all my family’s gone now, so. So I’m the only surviving person in my family and I just lost my sister a couple years ago to diabetes, so yeah. I mean it’s a lot harder I think for me because I have to resource out you know to do just minor things around the house, you know that are too much for me. But, you know I have my good days, I have my bad days, so. So I’m still learning to pace myself that one I’m, it’s going to take me, I may never learn how to pace because when I start to feel good then I want to get as much done as I possibly can. Because when I am not feeling good I can’t do a thing. And so then things pile up and then when I feel good then I need to get it all done, and so that pacing, I don't know if I’ll ever get the hang of that one. But, other than that I think that the programs are very, very beneficial for people who really want to you know really need them, you know?

Memory Aids for Brain Fog and Forgetfulness

Our interviewees described use of lists, calendars, iPhone or smart phone reminder systems and applications, and planners as compensatory strategies to combat memory irregularities. Toby said he took lectin to help with his thinking. Below Veterans share techniques to help with brain fog and forgetfulness.

 

Carrying a day planner has helped Andrew immensely.

Carrying a day planner has helped Andrew immensely.

Gender: Male
Birthday: December 1963
Racial or Ethnic Identification: Caucasian
Branch of Military: Army
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I had to start carrying a day planner, I’ve carried a Franklin day planner since 1993. I have to write everything down, or I forget to do it. So, my whole life is, write it down the moment someone tells me to do something. iPhones have been a Godsend to me because I can tell Siri to remind me on a certain day to do stuff. And I live off of my calendars, checklists, and stuff like that. Otherwise I would be a bloody mess. But before that it was a list, list, list, day planner, day planner, day planner, I’m a Franklin planner addict. Otherwise I would have been probably a bum on the street because I couldn’t remember squat. I just really struggled and the tests confirmed it.

 

“Patty” takes lots of notes to help her remember things.

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“Patty” takes lots of notes to help her remember things.

Gender: Female
Birthday: June 1964
Racial or Ethnic Identification: Caucasian
Branch of Military: Army
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I have taken speech therapy more than once, and I think they gave me some tools to help. And I think they help if I remember to use them, which is a challenge. So, that’s one thing I do. Is this I think having tools could help. Writing things down, I have a lot of notes, I rely on notes a lot. And just I think I tend to gravitate more towards casual encounters instead of in-depth encounters of people, friends. Because it’s just easier that way. Like neighbors, I’ll chit chat with neighbors, that’s great. I can talk to my neighbors that’s fine. But I don’t want to engage any deep relationship things, because it’s challenging, and you don’t want to do that. I just think like I said, I wasn’t told- I don’t really read books a lot in part because I can’t really- I lose tense, I don’t really focus on it well enough and remember what I read. For me it’s just finding things you enjoy like nature, exercise, being outside. And just relying on those things to keep you active and engaged in things. Yeah. And hang out with people who are talkers, so they do all the talking. And you can be- I’m a great listener. And I gravitate towards listening engagements.

Participants Try Different Strategies to Find Something that Helps

 

Brian uses meditation and soothing sounds to help him sleep.

Brian uses meditation and soothing sounds to help him sleep.

Gender: Male
Birthday: April 1967
Racial or Ethnic Identification: Caucasian
Branch of Military: Army, Air Force, and National Guard
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I used to do it at night to fall asleep. I used to have something on my cell phone with like either different speakers or different music, just calming things that would shut my mind down because that's my problem. When I wake up, my mind just, boom. It starts, and I can’t shut it off. But then it did help too. I don’t know why I quit. I probably just didn’t do it long enough to become a habit, but it definitely did help me get to sleep and feel calmer.

 

Hyperbaric oxygen therapy was Jean’s most successful treatment modality.

Hyperbaric oxygen therapy was Jean’s most successful treatment modality.

Gender: Female
Birthday: February 1958
Racial or Ethnic Identification: Caucasian
Branch of Military: Air Force
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The hyperbaric oxygen therapy made the biggest difference in my life out of anything. I’m not cured, and I still have days, but it has made a huge difference in my quality of life. I mean, I still can't do a lot. I’m not going to go rollerblading. That would just be stupid at this point, but you get a little older, you get a little wiser. You don't do the things that are going to hurt, because I have some issues with balance too, so that just wouldn't be a smart thing to do. But I don't have as many bad days as I had, and it's the hyperbaric oxygen therapy that really made a huge difference in that. And that was, let's see, maybe four or five years ago I think I had that. I did 40 sessions, and that's really made it, it's made life bearable. It's made life bearable.

 

Heather tried all sorts of natural remedies for her symptoms.

Heather tried all sorts of natural remedies for her symptoms.

Gender: Female
Birthday: November 1969
Racial or Ethnic Identification: Caucasian
Branch of Military: Marine Corps
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Under pressure and stress I was losing my ability to remember all that stuff. So I would say about the time I hit 45, is where the real big changes started to take place. And I felt, instead of gradually declining, I just felt like I was nosediving. And I don't know if it’s the age factor, or, I’ve read some stuff about oxidative stress, and I was always trying to push my body to stay in shape, and maybe the oxidative stress. I’ve taken so many different things to try to, spent money on different things trying to help with all those issues that different things claim. I mean we did MonaVie, we did Kombucha before it was ever sold in the grocery stores, my mom had me fermenting it. Anything to try to help me, 25 years ago. There was another one I spent a bunch of money on. I tried CBD, I’ve tried the stuff, this is like a sixty dollar bottle, CBD, I even tried THC tincture. I don’t have good results with any of that. I’m on CoQ10, turmeric, I mean if it’s out there, and it says it helps any of that stuff I’ve tried it. And, so May of this year I started this kratom and it’s been a lifesaver for me. It, if I hadn’t had this stuff, you guys would probably be up in the bedroom talking to me, while I was in bed because I literally can’t do anything. I just don’t have it in me to get up and do anything, fatigue wise, and pain wise. But this stuff really, really helped. I have a nerve pain that’s been going on in my arm, that it doesn’t help. So the doctors have been trying to give me different medications for that, and they had me on some gabapentin. Bad combination. It wasn’t good for me. So I just got off of that. And I’m on a new one, that seems to be helping. And I’m sleeping better, and this pain isn’t keeping me up. But this stuff works on all the muscle, I mean it keeps it at bay, I mean it’s still always there. I’ve been diagnosed with fibromyalgia, severe fibromyalgia, severe chronic fatigue.

 

Supplements like lithocholic acid and DHEA and meditation help Andrew.

Supplements like lithocholic acid and DHEA and meditation help Andrew.

Gender: Male
Birthday: December 1963
Racial or Ethnic Identification: Caucasian
Branch of Military: Army
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You know, when that nutritionist gave me that regimen for vitamins, there were certain things that, you know, as I could afford it, it was expensive, it was expensive to maintain. You know, to actually buy good quality vitamins and stuff like that. But some of the ones actually, you could feel, significantly made a difference. The vitamin D actually was significant! I had to make sure I stayed on that. I have a list at home. Lithocholic acid was a big one for me. DHEA was important to me. I have to make sure that I can sleep. I have a real hard time sleeping. So, when melatonin first came out, I was really into that as fast as I could. The VA has had me on trazodone for quite some time, probably years. Meditation, big big big big big in meditation. You know I have a Silvan tape that I listen to religiously. It’s a deep relaxation. It’s like a… it’s hard to explain. I have a first gen iPad I won’t get rid of because it’s got a tape and then they stopped actually upgrading, so it won’t load on any other. So, I protect that little iPad like it’s a life breath to me because it’s got that Silvan meditation on it. And I can’t put it on anything else, I can’t get it to upload on anything else. Even though I just found it on YouTube so, I’m a little relieved, because I can actually put that on my library now. I found that certain Silva… because I’ve tried every other meditation, but that one just works for me. It does this body feedback. Where it starts at the top of your head, and talks you into relaxing your eyes and everything else like that. It just works for me. And I’ve tried them all. I have tried them all. I am a meditation junkie.

Avoidance of Certain Chemicals to Reduce Chemical Sensitivity

Some struggled with sensitivity to chemicals and smells. Over time, a few learned what triggered headaches and other reactions and avoided those things.

 

Mike avoids strong chemicals like bleach and various detergents.

Mike avoids strong chemicals like bleach and various detergents.

Gender: Male
Birthday: December 1963
Racial or Ethnic Identification: Caucasian
Branch of Military: Army
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My lead is three, my lead was three times higher than the normal population. Lead is a heavy metal. Arsenic, zinc were all elevated. So, as you see, I still have all the good paperwork. I started seeing, back in somewhere around 2003, a neuropathic doctor. I wasn’t going to just keep taking these pills and nothing happening. And she's the one who suggested I do all that. And when that came back, she said hey, you really need to start chelation therapy if you want to, you know, and I did. So I did. I paid for it out of pocket, and VA kind of laughed at me. Fine. That's fine. I’m still here. A lot of my friends aren’t, so I don't know if it's because of chelation therapy or not, but it definitely removed some of the heavy metals, I’m sure, if it does what it's supposed to do. But for them not to accept those results and then tell me that it's not a reputable lab, really? Where is the VA, how does the VA define who is reputable? I mean, they're still in business to this day, so, I don't know. Anyways, my lead came back three times higher than normal. Zinc and arsenic were also elevated. So was, I forgot to write it down. It was strontium. I’m not quite sure what that is, but that's very elevated, as a matter of fact. It's in the red. So whatever strontium is, I never did the research to worry about it. So after I started seeing her, and she saw that, we did the chelation therapy, and she suggested a few other things, and then that's what I did. I also, and this is really important, and I preach this to every Gulf War Vet that I come across who is having problems. I mean, I preach it. I’m at the pulpit that way. I remove as much as possible all types of industrial chemicals. Bleach. Anything scented except for essential oils. I've learned to use essential oils. They help me quite a bit through my diffuser. But I’m talking about toothpaste, perfumes, nail polish, dish soap, bar soap, laundry detergent, and common cleaning supplies. All that crap is out of my life. I mean, I don't use it. I will not use it. For one, it causes me a lot of problems, and you'll understand here when I finish. I’m almost finished up, but smells seem to really set my whatever it is. You guys call it panic, or the VA calls it panic attacks. I call it my body is reacting, and then, yeah, it might go into a panic attack, but it's because my blood pressure just goes up, I start feeling really weird, and I pop the clonazepam, and I come back down and calm back down.

 

Shannon avoids anything with petroleum.

Shannon avoids anything with petroleum.

Gender: Female
Birthday: December 1964
Racial or Ethnic Identification: Hispanic
Branch of Military: Army
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I just recently went through my whole bathroom, and threw away everything that contained petroleum. There wasn’t any particular reason other than a personal choice to get rid of chemicals that I felt were dangerous to my body. So I got rid of all, everything that was petroleum. And so, no, I don’t use anything in particular. You know I just, I’ve chosen to use cocoa butter but because I don’t want to, and coconut oil because I don’t want perfumes, because perfumes trigger also. So, yeah. I would love for the VA to have an alternative, I have requested that many times, I’ve had certain physicians and whatnot do some research on it. Never have gotten a definite answer other than, no, that the VA doesn’t cover that and doesn’t have that option. But it would be kind of nice to have that option for people who don’t have the choice of taking medicines.