NickWe are writing to you in desperation for our son, brother, father GySgt Nicholas J. Avery, a retired United States Marine reservist (21 years), Operation Desert Storm and Operation Iraqi Freedom war veteran. Nick is currently living at the Ann Arbor, Michigan Eisenhower Center for Traumatic Brain Injury for conditions due to his diagnosed Post Traumatic Stress Disorder and recent diagnosis of TBI (Traumatic Brain Injury) from the Amen Clinic in Reston, Virginia on May 9, 2013 that was paid for out of pocket due to Nick’s families frustration at the lack of support given to Nick by the VA system. He has suffered tremendous grief in his personal life, and he continues to struggle in his will to thrive in civilian life due to causes related to his service of this country expounded from his home life. Because of his A-typical signs such as headaches, dizziness, outburst, to frustration in his ability to care for himself, He can no longer communicate effectively, bathe, dress, or feed himself. Do to his TBI and symptoms of PTSD, his personal and professional life has been dramatically affected and we fear for his safety and well being. We are asking for your assistance in getting help on behalf of our son, brother, father one of Michigan’s heroes, a United States Marine.
Nick’s military career has taken him down a long and Patriotic road. He attended Howe Military School as a sophomore in high school and graduated with honors in 1984. He was a Company Commander, active in the Rangers, weight-lifting, Bible study, and played varsity baseball, as well as received a scholarship with the United States Air Force Academy for his talent as a varsity football player and his academic performance. Nick chose to forgo this honor because he felt compelled to serve his country for, what he felt was a more elite group of individuals, the United States Marine Corps. Nick felt he was capable of meeting the physical and mental challenges the USMC threw at him, and he met those challenges with determination for 21 years. His love for his country and the privilege to serve in her defense and the freedoms of her people was sacred to him.
In 1990-91 Nick was deployed for Operation Desert Shield/Desert Storm. He was informed of his 50% life expectancy for this deployment, but he told his family he was willing to do whatever it took to ensure the freedom of others, even if it meant sacrificing his own life. Fortunately, he did not participate in any combat action and he seemed unaffected by this rather short deployment.
After he returned home from Kuwait, Nick was married and started a family. He worked in administration for A&B Environmental Services, a family-owned business. Life with his family and at work seemed to continue as normal until Nick was deployed in 2003 for Operation Iraqi Freedom. We learned he was to be part of the initial convoy leading the way to Baghdad with a water-purification team (We recently found out that while in Iraq Nick was in an engineering group that was responsible for deactivating IEDs’). After about eight months of deployment to Iraq, he returned home and everything seemed to fall back into place from where he had left.
Several months after returning home , Nick’s family knew without a doubt that Nick had been changed somewhat by this war. There were a few incidences where he angrily refused to participate in family events, such as paintball wars or fireworks. He indicated this loss of interest for these events was due to his service while in Iraq, which he never went into detail about. Eventually, Nick appeared to withdraw from his immediate and extended family. Nick had noticeable outburst of anger, periodic headaches that he would take ibuprofen like candy for and minute mistakes that no one though of at the time. He was quieter at family functions and stayed at work after hours. He transferred from his Marine Reserve unit, which was due to re-deploy to Iraq, and the new unit he was assigned to made house calls informing families of their fallen Marine. After only two emotional visits in which had to tell families of the loss of their loved one, Nick retired from the Marine Corps, and spoke rarely of his service in Iraq and at home. It was apparent Nick had seen or done things while serving with the Marines that had changed his demeanor, his psyche, and his overall mental status.
His home life was affected greatly. His relationship with his wife deteriorated and she eventually filed for divorce. In 2007 Nick rekindled a close relationship with his sister Kathy, because her husband had been deployed to Iraq. They spent many hours talking about their children being affected by war, the military and Iraq, and work, but Nick didn’t mention in detail his experience while deployed, except one. He mentioned an incident involving a family being used as a human shield while his men were being shot at from the same direction, from a bridge. He said he ordered his men to shoot in the direction of the shots, which was also the direction where the family was. He did not go into detail, and he does not remember this incident today. He also shared with the rest of the family of having to point his M-16 at a young Iraqi boy who was running toward his vehicle, and he said he yelled repeatedly for the boy to stop. Nick never concluded the incident other than the difficulty of having to point a gun at a child, reminding him of his own son. He also mentioned a story that when his group finally made it to Baghdad and after many hours of sleepless stress, he relented and slept through an entire night of fire-fights, not hearing a sound or knowing what was going on around him (We found out on May 3, 2013 that this was an impossibility from a Doctor at the VA who retained Nick’s service records. We also learned that Nick had been exposed to 5 IED blast within a 50 meter or less range during his service in Iraqi Freedom. News that his family never heard before) That was the extent of Nick’s memories of his “war stories.”
In 2008, changes in Nick became more evident as he made errors in his accounting, miss spelled simple words and phrases, at time unable to write out checks, unable to perform task he had always performed before with no difficulty. In 2009 Nick was asked by his wife to move out of his home. His wife had filed for divorce. Nick’s decline became even more dramatic and his position at work had been reduced due to his increasing mistakes and his loss of many accounts for the business. He had been promoted to president earlier, in hopes that he would take over the family business, so our parents could retire. Unfortunately the struggles at work, his family’s increased struggles and his failed marriage all seemed to come “to a head” about the same time.
His performance at work suffered to the point where he was deemed unemployable. He was not able to concentrate while working on the computer, he had a difficult time recognizing numbers, even writing his own name on occasion was a challenge, His ability to read also began to decrease. He continued to work but he was unable to communicate effectively, often stuttering, or complete his thoughts, and his conversations seemed to jump around and made little sense. His position was reduced to mopping the floor, doing the laundry, and mowing the lawn. While mowing the lawn he would often “hear” bullets and screams. Whenever he was under any amount of stress or whenever he recalled his time served during OIF, he displayed involuntary twitching and constant heavy breathing. While at his nephew’s birthday party and watching the 11-12 year olds play laser tag, Nick became inappropriate and yelled out he was going to “shoot the little mother f—-,” because one boy was apparently winning in shots against the other boys. When at the Battle Creek airfield for a static display on the Fourth of July, Nick spotted a Mennonite man and woman and again, said repeatedly in a loud voice, “I want to shoot that f—— rag head!” These behaviors and language were very uncharacteristic of Nick and seemed to all stem from his recurring thoughts and nightmares of his time spent in Iraq where he was involved in life-and-death decisions, which resulted in the death of Iraqi citizens, including children.
It took Nick a long time to admit the guilt he had been carrying with him for over 6 years. It was May 2009 when Nick finally shared his experiences in Iraq, as his sister Kathy was helping him fill out paperwork in hopes of receiving disability from the VA. While recalling his time in Iraq, Nick admitted he wasn’t sure but he thought he may have shot the boy who was running at him. His memory was that his weapon was the only weapon being fired, and he heard the mother’s screams in his dreams. He felt responsible for the deaths of two Marines who drowned in Saddam Canal, and he relived the cries of the fathers when he delivered the news of their sons’ deaths. He would shake when he heard anything that resembled a gunshot, he sleepwalked, urinated the bed without waking, had night sweats, headaches and has had three automobile accidents because of his inability to focus while under stress. He had had thoughts of ending his own life and constantly battled depression, which he tried to hide through drinking alcohol for a year or two. Today, Nick cannot see items directly in front of him, he has difficulty following one to two-step directions, he requires assistance with dressing, bathing, eating and is now incontinent and wearing depends. He can no longer have a conversation as he speaks one to three words, or parrots what you say. Nick no longer has any social skills. Nick endured years of headaches, physical and emotional pain, regret, guilt, shame and disappointment. His heart-wrenching silence has proven detrimental to his health, destructive to his psyche and damaging to his ability to thrive in society and in the workforce. It took Nick moving out, getting a divorce and being urged to apply for help through the VA that he finally “broke down” and shared some of his horrors of war, but not without social and emotional consequences.
Nick received an EEG in Oct. 2010 based on the symptoms he was displaying. Because he had an abnormal reading of his brain and the doctor thinking that perhaps Nick had had a stroke, an MRI was then ordered. However, Nick’s MRI was supposedly clear showing no clear evidence of a traumatic brain injury, since that time Nick has had another MRI and 2 PET scans which showed left side slowing of the brain (Nick had been seen by 5 Neurologist, in which one Doctor, a Nuclear Neurologist, stated Nick had Alzheimers, a fact that has been disproved by a final specialized PET scan on March 15, 2013). In June 2010 Nick underwent PTSD group therapy, which he completed after 9 sessions and was told he had “graduated”. He was recommended to see a speech therapist, Dr. Debra Gleason, for his physical and cognitive impairments and was recommended for a sleep study. He visited a neurologist after Dr. Gleason felt Nick had reached a plateau with her. In June 2010 we contacted the Purple Heart in Detroit, Veterans of Foreign War, as well as Disabled American Veterans. All organizations stated they were unable to help Nick at that time. Next, we sought out help with Military One Source and the family was contacted immediately by Steve Walker with Wounded Warrior. Through this contact Nick received an advocate through the VA, and his disability claim was expedited. Between his mother, father, and three younger sisters, Nick has been accompanied to every appointment between the Battle Creek VA and the Ann Arbor VA. We have had many questions as to what was the cause of Nick’s deterioration, and with every question, we were given very little explanation, which has left us with more questions and no answers as to what was wrong with Nick and what we needed to do to help him. (We later learned that in Nick’s records, one doctor stated that they felt Nick was faking his illness, A fact that caused a wall in getting Nick help)
Shortly after the family visited the Ann Arbor VA with Nick in the spring 2011 and was told by the neurosurgeon, Dr. J. Burke, that Nick’s problem was “in his head.” Shortly after that visit my mother received an appointment card for Nick to see a psychiatrist within the Battle Creek VA. My mother attended Nick’s first appointment with Dr. G. Bandlamudi, and his comment to Nick was, “Why are you here? I could be helping someone else that needs help.” My father immediately went back to the VA and requested Nick be assigned a new doctor.
We finally decided we needed to seek outside help, as we felt we were receiving a lot of “lip service” and getting the “run around” from the VA. Our faith in the VA system was decreasing dramatically with each day our brother/son continued to deteriorate. We researched the Amen Clinic and the New Jersey VA Combat Related Illnesses Research. In the meantime, Nick started visiting Mr. Joseph Noto, LPC for counseling on a regular basis. Because Mr. Noto was a former Air Force pilot, Nick was given a military discount for his fees, which Nick paid out of pocket. We asked Nick’s Primary Care provider, Dr. C. Anguras, if we could get a referral for Nick to any clinic specializing in PTSD/war related illnesses. We were told that because the Battle Creek VA provided those services, she would not write a referral, even to the New Jersey WRIISC VA because Nick was not assigned to them. We then contacted the Wounded Warrior and asked for suggestions or recommendations of where my brother could go to get help and was told that because the VA provides those services, they would not cover Nick’s fees if he were to go somewhere else. At Nick’s appointment with his primary care doctor in September 2011, Dr. Anguras failed to make eye contact when entering the room and asked, “What is it you want from me?” Nick’s sister Jill asked for a referral to the New Jersey VA. When looking over Nick’s paperwork, the doctor appeared frustrated and confused when she stated, but also asked Nick, how could he not remember his own birthday. She then signed a referral and left the room. That was the last time Nick was seen by Dr. Anguras, as both my mother and sister Jill requested a new primary care physician for our brother.
My mother pleaded Nick’s case with his advocate. Laura researched and was able to schedule an appointment at Mary Free Bed in Grand Rapids in November 2011. At this appointment, we were told Nick was suffering from PTSD and NOT a TBI. Because reports from his MRI showed no supposed traumatic brain injury, Nick could not receive treatment from MFB, due to strict regulations in funding for veterans.
Any assistance in recommendations for getting Nick the treatment and help he needs for his TBI so he can regain some of his function and have a quality of life would be greatly appreciated. Nick’s family has had to go OUTSIDE the VA system in order to get Nick the treatment he so deserves and needs. It is our hope to have our son, brother and father “back” and to be able to credit our government for taking care of its own men and women who served their country selflessly.
James & Elaine Avery, Parents
Kathy Kreykes, Sister
Debbie Lampert, Sister
Jillena Kellogg, Sister
Suzannah Avery, Daughter
Storm Avery, Son
Post Script: Nick is now living at a TBI (Traumatic Brain Injury) facility in Ann Arbor Michigan (since July 2013) where he is receiving treatment for his injuries despite the fact his diagnosis is still not certain. Nick IS improving each day and is now off medications that “snowed” him and left him in a fog. Nick has also been treated with hyperbaric oxygen treatment or Hbot treatment in hopes that this will help his brain cells. Nick’s family is hopeful that he can and will make some sort of a recovery. Our BATTLE continues as the VA has sent us a letter stating the will no longer grant Nick any additional help financially for his treatment at the Eisenhower Center. Our battle now is to find a way to keep Nick at the Eisenhower Center for his TBI treatment and rehabilitation. Nick was admitted at the Ann Arbor VA in February 28, 2014 after 3 days of bringing him to the ER for a dramatic decrease in his mobility, speech, and ability to feed himself. The Ann Arbor neurologist became frustrated on the 3rd day and told Nick’s Mother and sister Jilly, “You cannot keep bringing him in here every day. ‘His decline is due to his dementia and nothing else.’ It is evident that he is not suffering from seizures but is dying and you need to accept that”. Nick was admitted, and EEG was performed and Nick was suffering from focal seizures that were happening almost continuously. We no longer seen that Neurologist but rather interns who stated his test showed he was probably having seizures since December or more!!! This is unacceptable to Nick’s family that he once again was ignored and made to believe there was “nothing” wrong. Please do not ignore him any longer. Give Nick the opportunity to receive care that he deserves as a Marine, a Veteran who served his country.
To Whom it May Concern,
This letter is in reference to the social, physical and behavioral changes I have observed in GYSGT Nicholas Avery. I have known GYSGT Avery for approximately 20 years and only after his last deployment to Iraq did I notice a considerable change in him. GYSGT Avery has endured several unfortunate situations since being back home that have affected his family and home life, his ability to work, and his good reputation. I believe GYSGT Avery’s deployment to Iraq is the main source for the evolution he has undergone and essentially become a different person.
I have known Nick Avery since May 1988. He was always a well-kept, articulate and sociable business man. He was confident at his job with A&B Cleaning, and he was self controlled. Nick was proud to wear the uniform of a US Marine and was certain of his job in the Marine Corps. He was involved with his immediate family’s activities, and involved with his extended family’s events as well. For the years that I have known Nick, I knew him to be a happy, healthy, loving and self-assured man.
In 2003 Nick was deployed with the Marines to serve during Operation Iraqi Freedom and upon his return, I have seen a gradual decline in Nick physically, emotionally, and socially. His desire to interact with the extended family became less frequent. His marriage appeared to be more and more strained. And he was quieter, more guarded and less social. It wasn’t until within the last year that I have noticed an even considerable change in Nick. He endured a divorce he did not want, and his family was having issues that concerned him. His position at work had been reduced. His ability to focus and communicate and complete his thoughts declined dramatically. Whenever he recalled his time served during OIF, he displayed involuntary twitching and constant heavy breathing, which he continues to do at the present. As a Physician’s Assistant in the Michigan Army National Guard for 25 years and having been deployed to OIF myself and being an active, primary care PA it is my professional opinion that Nick is suffering from severe PTSD and depression. He has displayed cognitive impairment and symptoms of dementia. Although he is currently being treated through the Battle Creek VAMC, he is unable to perform menial tasks, such as reading, writing, paying for bills, etc…and his employer has determined that he is currently unemployable, who has confided this in me. These behavioral changes all stem from his recurring thoughts and nightmares of his time spent in Iraq where he was involved in life-and-death decisions, which resulted in the death of Iraqi citizens, including children. This all leads me to give a professional diagnosis of PTSD with severe depression and probable TBI. Contact me if you have any questions.
MAJ Todd M. Kreykes, PA-C
Michigan Army National Guard, Ret.