Veterans Care Today: Antoinette Lee Toscano Of WhitewaterTV On How The US Has Improved Its Care For Veterans Over The Past Five Years
An Interview With Eric Pines
“Failing” is not a bad thing. However, through our perceived failures, we learn the most significant lessons, make the biggest discoveries, and comprehend the most about ourselves. For example, I “failed at being a CEO” because my persistent health challenges and disability prevented me from staying in this career. But the “failure” led me to a more rewarding and healthier lifestyle and career.
The daily headlines remind us of how countries around the world care or do not care for their military service members. How does the United States hold up with regard to how it cares for its veterans? We know in the past questions have been raised about the VA system, but it seems that a corner has been turned and veterans’ care has improved. How exactly has the VA system been improved? How does the US care for veterans compared to other comparable countries? What exciting new technological or methodological innovations are being used to improve veterans’ health outcomes? To address these questions, we are talking to successful physicians, healthcare workers, veterans, or other VA employees and officials who can share stories and insights from their experience about the state of veterans’ care today and how the US has improved its care for veterans over the last five years.
As a part of this series, I had the pleasure to interview Antoinette Lee Toscano.
Antoinette Lee Toscano, MBA — is an 11-year United States Army veteran, a 55 year old sponsored adventure sports athlete on WhitewaterTV on the XOTV.me platform and Hisense smart TVs.
Thank you so much for joining us in this interview series! Can you share the most interesting story that happened to you since you began your career?
My upcoming — summer 2023, military memoir is titled ‘Four Hours to Live — Memoir of a Woman Soldier’ because I have been through several physical and emotional traumas during my military service, including #MeToo.
After leaving the Army, I joined the Information Technology (IT) sector, advancing from a Call Center Analyst to Chief Executive Officer (CEO). But worsening persistent health challenges resulting from a Traumatic Brain Injury (TBI) and spinal injury I sustained while in the Army caused me to resign. I was using a walker, a service dog, and a full-time caregiver by this time. My occupational therapist recommended that I take up archery to improve tasks like focusing on reading and conversations. And my physical therapist recommended whitewater kayaking for recreational therapy.
So, I showed at my local Team River Runner chapter with my walker, service dog, and caregiver and asked, “can I learn how to kayak?” The answer was yes, and nine years later, I am a sponsored adventure sports athlete, adventure lifestyle influencer, model, and digital content creator. I no longer need a walker, and my service dog is mostly just the family pet. And I have an exciting freelance career in the outdoor industry.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
People with disabilities and persistent life challenges are often told to think small and not expect too much from life and ourselves. Our friends, family, and healthcare team often warn us that we are not getting enough rest when from our perspective, all that we do is sleep. But I learned to listen to what my body is telling me and consider these messages while taking professional advice about managing my healthcare. I live in this body, so I know it better than anyone. In the past, when I listened to the direction of friends, family, and my healthcare team about “resting as much as possible,” I became sicker each day.
But after taking control of my health as an active participant, listening to my body, going outside, and beginning to adventure, I became healthier.
Managing my hidden disabilities and general health and well-being means that I have good days and challenging days. Even on a good day, I often feel exhausted, and by 3:00 pm, I need to connect to an Alpha-stim device and take a nap. Roughly four days a week, I can hardly get out of bed.
This is my new normal.
However, Erik Weihenmayer, the first blind person to summit Mount Everest and kayak the entire Grand Canyon, inspired me with this quote.
“The truth is that adversity is a part of most days. Whether you are ultimately weakened or strengthened by each event, or the accumulation of events, will depend on you first mastering the ability to Take It On!”
– Erik Weihenmayer
And the lesson here is despite my disabilities; I can still live as big a life as I can envision.
And my life is filled with incredible people, amazing places, and adrenaline-filled adventures at the intersection of conservation, health, and wellness.
Are you working on any exciting new projects now? How do you think that will help people?
Through my philanthropic work, I developed the free National American Adventure Sports Club powered by Vibe Tribe Adventures, in collaboration with WhitewaterTV and local parks and recreation departments like the City of Loveland, Colorado Parks, and Recreation where I am a Commissioner. This inaugural club is demonstrating how the power of grassroots efforts, non-profit, for-profit, and governmental collaborations can provide no-cost, year-round outdoor recreation and conservation education opportunities for Americas underrepresented and marginalized communities.
How would you define an “excellent healthcare provider”?
When I consider someone an excellent healthcare provider, I base my opinion on three character traits:
- A customer service mentality with their patients. This means they are friendly, approachable, patient, empathetic, and a partner in managing my healthcare. But unfortunately, some physicians dismiss your concerns and push you toward their pet research project. And they become hostile and bullying in their quest to get you to agree to a treatment you feel is not suitable for you. First, given my history of allergic reactions to a natural substance like monk fruit that causes severe migraines, and a preventive medication that suddenly sent me into anaphylactic shock after taking it for ten years without a problem. As a result, I am very cautious about adding new things to my diet or healthcare routine. And I need my physicians to respect this boundary.
- An appreciation for the value of Western Medicine supported by traditional or herbal medicine. Some people like me are susceptible to anything developed in a laboratory. Including gluten and genetically modified foods, so, I grow most of what I eat in my organic garden and greenhouse. And we can what we grow to consume during the winter. But if there is an obscure side effect that one in one million people experience, I am one of those people. For example, I cannot even use some natural sweeteners without experiencing a traditional or ocular migraine. In the past, doctors have not listened to my medical history regarding anaphylactic shock, food and drug allergies, and other drug complications. As a result, my kidneys do not function properly after years on multiple medications known to cause kidney damage. Today, I ask my healthcare providers to help me evaluate herbal remedies whenever possible. But many doctors dismiss my concerns.
- A clinician that does not act as if they are the boss of my body. I expect my healthcare team to make recommendations but ultimately leave me the final decision on a course of treatment. The reality is that I have to live with the toll their “treatments” take on my body. In my case, I respond better to natural protocols. Most of the time, Western Medicine solves one problem but creates a different health challenge for me. I always defer to my trusted family member — — caregiver’s advice when I am having what I call a “bad brain day,” and it is challenging to communicate and process information. And I defer to my physician’s expertise, but the final decision on accepting or rejecting a protocol is my decision. And so far, this approach has dramatically improved my quality of life. Before, I was merely existing. I live and thrive today despite my ongoing health challenges and disabilities because I have taken back agency over my body.
Ok, thank you for that. Let’s now jump to the main focus of our interview. Based on your experience can you please share three recent improvements to veterans care that you are really pleased about?
The three recent changes within the Veterans Administration (VA) that I am most happy about are:
- Improved Diversity, Equity, and Inclusion training. First, in my experience, VA clinical staff do an excellent job of understanding the people they serve, de-escalating situations with agitated patients, avoiding trauma triggers, and delivering healthcare with respect, dignity, and patient privacy. But that is not the case with the first and last people you contact within the VA system — the front desk and administrative staff. Therefore, the current DEI and customer service training are very much welcome.
- The adoption of the “whole health” model — the VA’s innovative approach to delivering healthcare centers on what is important to me, the patient. And the whole health program empowers me as a patient to advocate for what is important to me and my health and wellbeing — # LiveWholeHealth.
- An expansion of the care in the community program. Care in the community allows veterans like me to receive timely healthcare at a non-VA facility like a hospital or doctor’s office visit under some circumstances. This means shorter wait times for access to care. And access to specialists and advanced diagnostic and treatment equipment that are unavailable or not available quickly at a VA facility.
In contrast, can you highlight three areas of veterans care that still need improvement? What would you suggest needs to be done to address those challenges?
The three most significant areas of the VA system that need to be addressed to benefit patients, administrative staff, and clinicians are:
- An improved appointment scheduling system. Today, when a clinician needs to cancel or reschedule a veteran’s appointment for any reason, there is no process to notify the patient. As a result, patients who have taken off work, gone through great difficulty arranging a ride to their appointment, or overcame depression or anxiety about driving are not notified about the cancelation. And when they arrive with an appointment card mailed to them from the VA, they can become agitated by a seemingly indifferent or unempathetic front desk person. In my experience, the administrative staff did not explain that I was not wrong about having an appointment. My appointment was canceled. And I was not notified. I would expect in this situation that the front desk person would apologize for the inconvenience, ask if I need to speak with the urgent care doctor today, and offer to reschedule me for an appointment within seven days.
Sometimes, I have waited four to six weeks for an appointment only to arrive and be told that I must wait another four to six weeks. And sometimes, I urgently waited to discuss a test result or medication change with my doctor. Situations like this can be avoided if an electronic appointment cancellation notification process is modified to the VA’s appointment system.
2. More access to preventive and healthcare management resources. For example, each veteran could have an annual budget for purchases. They could use their funds to purchase health and wellness products and services like access to stretching programs through an app on their phone. Buying a yoga mat or paying for a gym membership or a fitness coach would help many veterans without the disposable income to buy these things for themselves. In my case, electronic devices like my CPAP, Smartwatch, BioWave machine, and Alpha-Stim device are critical components in my day-to-day healthcare management. But when the power goes out in a storm or when I am in the backcountry on a camping, hunting, fishing, hiking, or kayaking trip as part of my recreational therapy, I do not have a way to power or recharge these critical devices. It took me four years to save enough money to buy a solar panel and portable generator. I think the VA should offer financial support to veterans genuinely trying to manage their health proactively.
3. Demystifying the VA healthcare system. Despite some cognitive challenges, I have a higher than average IQ and an advanced degree. But the socialized medicine that is the VA system is so dynamic and complex that I am often overwhelmed in my attempts to get the care I need. Just imagine how difficult the VA system is to navigate for the veterans, family members, and caregivers with fewer resources. The complexity, the inherent confusion about which person or department to contact, and how to promptly get the healthcare services I need have prevented me from getting medical help in the past thirty days. I have felt bullied and intimidated by front desk staff. And VA security guards “mean-mug” me with their hand on their weapon as if I am about to commit a crime. This is a very intimidating experience for a black woman to endure. And I have heard male combat veterans say this behavior is very triggering. Veterans should not feel like they could be shot at any moment while getting care at the VA. When I have what I like to call a “bad brain day,” and I cannot remember how to start my car, recall words, and keep up with conversations, I cannot advocate for myself. I also cannot navigate the long telephone hold times and admin staff who sound annoyed, impatient, and hostile toward me when I can hardly care for myself on those days. The entire system must be easier to navigate for patients on their worst days.
Lastly, the VA has a very subjective process where VA staffers can “red flag” a veteran when the staffer feels the Veteran’s behavior is disruptive or disrespectful. “Too many” of these red flags could cause veterans to lose access to VA healthcare facilities. A VA staffer used this system to retaliate against me. I went through a complaint process that involved enlisting help from my Mayor and Congressional Representative. And oddly enough, there is no similar “complaint process or complaint department” for Veterans to complain about unprofessional, harassing, and other unwanted behaviors on the part of VA staff. My complaint was credible, and the VA took swift action. However, the inequity of this situation is this. A VA staffer has all the power. For any reason, they can red-flag a Veteran for abusive and disruptive behavior; in my case, I calmly and professionally advocated for myself, and the VA staffer red-flagged me. The VA decided my case without contacting me for my side of the story. And I received what felt like a threatening letter from the VA notifying me of the complaint against me after the “Veteran’s Experience Liaison Office” determined. This system created an unfair power dynamic. I hope the VA will implement a system that allows for a complaint process for Veterans in the future and make the staffer’s complaint process more objective.
From your perspective how does the US care for veterans compared to other comparable countries?
I have met veterans from Australia, Britain, and Russia. In my opinion, the U.S cares for its veterans in a manner that is comparable to most and slightly better than other nations.
However, I think all countries, including the U.S, do not provide a safe, welcoming, supportive, and timely re-entry and healthcare program for their veterans.
For example, after leaving the Army with several diagnosed conditions, it took the VA five years to award me benefits. Luckily, I had private health insurance. But I thought it was unconscionable that a “disabled veteran” like me had to pay for the medications the VA prescribed me and other co-pays until the VA awarded me disability benefits.
“You broke me. Now I have to pay you to fix mix me?”
In addition I was shunned, called a “baby killer,” “warmonger,” and “domestic terrorist” by society and the media. Even someone I considered a dear friend told me that she could not be my friend anymore because the news said she would be “inviting danger into her life” by associating with a veteran. The hollow “thank you for your service” from an ungrateful nation is hurtful. And it negatively impacts our mental health on a routine basis.
What exciting new technological or methodological innovations are being used to improve veterans’ health outcomes?
The VA recognizes the anecdotal data demonstrating outdoor recreation’s health, social, and mental health benefits to Veterans like me. As I said, after learning archery, I improved my ability to focus on tasks like reading. And whitewater kayaking and other sports helped me improve weight loss, heart disease risk factors, balance, mobility, range of motion, and mental health.
For example, the VA currently helps fund programs through non-profit organizations like Team River Runner (TRR). TRR is the national 501(c)(3) that taught me how to kayak at no cost. Today, I have been a TRR member for eight years. And without the access to outdoor recreation, the camaraderie on and off the river, and a warm and welcoming community at TRR, I think my life would have been tragically different.
Unfortunately, the VA is taking the time to study the efficacy of outdoor recreation programs. However, veterans like me can tell them that it works and needs to be expanded immediately rather than after a long, expensive, and exhaustive study. And it is simple to implement because there are many non-profit organizations serving the veteran community with no-cost and low-cost recreational opportunities.
This is our signature question that we ask in many of our interviews. What are your “5 Things I Wish Someone Told Me When I First Started My Career”?
The five things I wish someone had told me when I first started my career are:
- My diversity — gender, ethnicity, and disability will often become an obstacle or challenge in the workplace. So, be prepared to handle questions and doubters professionally and from a position of strength. Because if you are unprepared when these situations arise, you might react emotionally and reinforce stereotypical thinking. My strategy has been rather than becoming angry; I use the situation as an opportunity to shift their perspective.
- If you take care of those you lead, they will take care of you through loyalty and excellence. This practice is how military leaders create loyal and disciplined teams and get those they lead to run toward dangerous situations despite the risk.
- “Failing” is not a bad thing. However, through our perceived failures, we learn the most significant lessons, make the biggest discoveries, and comprehend the most about ourselves. For example, I “failed at being a CEO” because my persistent health challenges and disability prevented me from staying in this career. But the “failure” led me to a more rewarding and healthier lifestyle and career.
- The people asking the essential questions are the same folks who solve the most significant problems. So, do not be afraid to question anyone about anything. Sometimes your question will get them to look at a problem differently and lead them or you to an innovative solution.
- Trust your intuition, especially when making a difficult decision. Our intuition comes from our “lizard brain” — the limbic system of the brain that is “phylogenetically primitive” and controls our fight, flight, freeze, fear, and other mental and emotional processes. Tapping into my intuition which I often feel as butterflies or a sinking feeling in my gut, allows me to “hear” or feel what a different part of my brain is telling me. The part of my brain that is not impacted by societal training, education, and experience because I already considered this training earlier in my decision-making process.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
Suppose you live in Chilean Patagonia, Malaysia, Hong Kong, Mainland China, the U.K., or the E.U., for example. In that case, you can access low-cost or no-cost outdoor recreation and access a community of adventurers. But if you live in the U.S., you must figure out how to afford the gear, apparel, instruction, and a community to recreate with on your own.
That is why I developed the free National American Adventure Sports Club powered by Vibe Tribe Adventures, in collaboration with WhitewaterTV and local parks and recreation departments like the City of Loveland, Colorado Parks, and Recreation.
Through this non-profit, for-profit, governmental collaboration, we provide no-cost adventure sports, backcountry, and water safety, wildfire prevention, conservation training, and a supportive community for underrepresented populations to get outside and adventure and join the conservation movement. We opened the first club in Loveland, Colorado, in 2022. And we plan to bring an American Adventure Sports Club to every community in America that wants one. Because some of the same barriers that prevent a black construction worker on the South side of Chicago from accessing outdoor recreation also affect a white kid in a wheelchair in rural West Virginia.
Grassroots movements like the American Adventure Sports Club are how “we the people” can solve complex problems without waiting for a governmental solution. The donations to support the American Adventure Sports Club ranged from $1.00 — to $25,000, and the impact will last for generations.
How can our readers further follow your work online?
Websites:
https://antoinettetoscano.com/about-me/
https://cultursmag.com/author/atoscano/
https://paddlingmag.com/stories/columns/flushed/kayaking-demographics/
Social Media:
https://www.instagram.com/whitewatertv_xotv
https://www.instagram.com/antoinetteleetoscano/
https://twitter.com/AntoinettesPen
www.linkedin.com/in/antoinettetoscano
Digital Content Creator/Brand Ambassador:
https://xotv.me/channels/359-whitewatertv
YouTube Video — 5 Things I Wish Someone Told Me Before Becoming a CEO
Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.
About the Interviewer: Eric L. Pines is a nationally recognized federal employment lawyer, mediator, and attorney business coach. He represents federal employees and acts as in-house counsel for over fifty thousand federal employees through his work as a federal employee labor union representative. A formal federal employee himself, Mr. Pines began his federal employment law career as in-house counsel for AFGE Local 1923 which is in Social Security Administration’s headquarters and is the largest federal union local in the world. He presently serves as AFGE 1923’s Chief Counsel as well as in-house counsel for all FEMA bargaining unit employees and numerous Department of Defense and Veteran Affairs unions.
While he and his firm specialize in representing federal employees from all federal agencies and in reference to virtually all federal employee matters, his firm has placed special attention on representing Veteran Affairs doctors and nurses hired under the authority of Title. He and his firm have a particular passion in representing disabled federal employees with their requests for medical and religious reasonable accommodations when those accommodations are warranted under the Rehabilitation Act of 1973 (ADA). He also represents them with their requests for Federal Employee Disability Retirement (OPM) when an accommodation would not be possible.
Mr. Pines has also served as a mediator for numerous federal agencies including serving a year as the Library of Congress’ in-house EEO Mediator. He has also served as an expert witness in federal court for federal employee matters. He has also worked as an EEO technical writer drafting hundreds of Final Agency Decisions for the federal sector.
Mr. Pines’ firm is headquartered in Houston, Texas and has offices in Baltimore, Maryland and Atlanta, Georgia. His first passion is his wife and five children. He plays classical and rock guitar and enjoys playing ice hockey, running, and biking. Please visit his websites at www.pinesfederal.com and www.toughinjurylawyers.com. He can also be reached at eric@pinesfederal.com.
Veterans Care Today: Antoinette Lee Toscano Of WhitewaterTV On How The US Has Improved Its Care For… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.