{ "version": "1.0.0", "segments": [ { "speaker": "Leah Bucholz", "startTime": "6.56", "endTime": "24.505", "body": "Hey, guys. It's Leah B from Prestige Veteran Medical Consulting. I am a US army veteran, physician assistant, and former compensation and pension examiner. So have you ever thought I was fine until I got out? So we're gonna talk about how why some conditions don't show up until years after service." }, { "speaker": "Leah Bucholz", "startTime": "24.665", "endTime": "39.98", "body": "K? So, again, have you ever thought I was I was fine until I got out? Why is this happening now? Or maybe someone has said, if it were related to your service, it would have shown up sooner. You know, it's ten or fifteen years later, and and this condition hasn't shown up until now." }, { "speaker": "Leah Bucholz", "startTime": "40.06", "endTime": "54.385002", "body": "So today, I wanna explain something very important. Not all conditions appear immediately. Some develop slowly. Some worsen over time. Some don't become noticeable until the body's ability to come compensate just starts to decline." }, { "speaker": "Leah Bucholz", "startTime": "55.32", "endTime": "67.479996", "body": "This is educational only. K? I gotta throw out my disclaimer. Not legal advice. If you need an accredited, you know, person to help you with your claims or strategy, check out va.gov." }, { "speaker": "Leah Bucholz", "startTime": "67.479996", "endTime": "86.88", "body": "I even have a little video about how to search their tool, their accreditation search tool. Find a VSO in your county or an attorney or a claims agent. They should be able to help you. Again, I'm a medical professional. I work with a ton of accredited, legal representatives, who asked me to review files for their clients and and help with medical opinions." }, { "speaker": "Leah Bucholz", "startTime": "87.52", "endTime": "100.305", "body": "But, again, this should be taken from the context of a medical perspective. Right? And it's, again, it's not medical advice either. It's just sort of VA related medical info. K?" }, { "speaker": "Leah Bucholz", "startTime": "100.305", "endTime": "126.409996", "body": "So let's talk about what's actually happening in the body for these conditions that appear years later. So the the body will compensate until it just can't. So when you're younger, your body is remarkably adaptive. You can do things like 12 mile road march, 20 mile road march, whatever. Carry heavy loads, sustain head, repetitive stress, push through an injury." }, { "speaker": "Leah Bucholz", "startTime": "126.57", "endTime": "137.30501", "body": "I know you guys I hear that from y'all all the time. I did it myself. So you recover quickly. Your muscles, will compensate. Your adjacent joints can take on that extra burden or load." }, { "speaker": "Leah Bucholz", "startTime": "137.54501", "endTime": "156.42", "body": "Inflammation resolves more efficiently. So compensate the the compensation is not, a correction for that. Right? If an injury or stressor occurred during service, the body may adapt, but it it doesn't mean it's gonna heal properly. Over time, that adaptation can lead to secondary strain." }, { "speaker": "Leah Bucholz", "startTime": "156.985", "endTime": "176.95001", "body": "And years later, symptoms might emerge. So the degenerative cascade, we've talked about this a ton in the past if you've seen a lot of my videos. Let's take the spine for for an example. You may sustain repetitive axial loading or trauma or strain in your twenties. At that time, your muscles are strong." }, { "speaker": "Leah Bucholz", "startTime": "177.11", "endTime": "187.26501", "body": "Discs are hydrated. Healing capacity is higher. You may have intermittent pain, but it resolves. Fast forward ten or twenty years. Alright?" }, { "speaker": "Leah Bucholz", "startTime": "187.345", "endTime": "196.79001", "body": "Your discs naturally lose hydration with age. Right? I I talked about this in another video recently. I personally lost an inch while I was in the army. K?" }, { "speaker": "Leah Bucholz", "startTime": "196.79001", "endTime": "217.975", "body": "I was sixty eight inches when I went in, and then I was sixty seven when I went out. And that didn't even happen over the twenty one years I was in. It happened, you know, after seven or eight years, I had already lost an inch. So if there was prior microtrauma, that segment may degenerate faster. This is sometimes called a degenerative cascade." }, { "speaker": "Leah Bucholz", "startTime": "218.295", "endTime": "238.03", "body": "Disc hydration, loss of disc height, increased facet joint stress, progressive arthritic changes, symptoms may not become persistent until structural compensation fails. Alright? That delay does not mean nothing happened earlier. It means degeneration progressed over time. It's cumulative, you guys." }, { "speaker": "Leah Bucholz", "startTime": "238.03", "endTime": "250.945", "body": "It's just cumulative. So post traumatic arthritis. This is another clear example. If someone enters a knee in their twenties, alright, you can get you can develop ligament damage. They can have a meniscal tear." }, { "speaker": "Leah Bucholz", "startTime": "251.185", "endTime": "270.68", "body": "We've talked about Adrian Peterson before, how he had that terrible triad in his knee. So we can get joint instability. They may return to duty and function for years. You you can you can overcome, but altered joint mechanics increase cartilage wear. Post traumatic arthritis often develops gradually." }, { "speaker": "Leah Bucholz", "startTime": "270.975", "endTime": "284.255", "body": "So I had a catastrophic shoulder injury. Okay? Both both of my shoulders. Yeah. I've I've went into detail on it on previous videos, but I was able to kinda recover from it over time after multiple surgeries." }, { "speaker": "Leah Bucholz", "startTime": "284.255", "endTime": "311.465", "body": "And and I was able to sort of get back to, you know, my my peak abilities. But, you know, that post traumatic arthritis still is gonna set in, and now I've got a ton of difficulty, especially in my left shoulder. I have a ton of pain, and dysfunction daily, but I I you know, that's the age degeneration problem. So sometimes it can take five, ten, or even twenty years to become symptomatic. The injury is gonna set that stage." }, { "speaker": "Leah Bucholz", "startTime": "311.70502", "endTime": "322.13", "body": "Time reveals the outcome. Alright? So nervous system sensitization. It's not just structural issues. Chronic stress and trauma can alter nervous system regulation." }, { "speaker": "Leah Bucholz", "startTime": "322.69", "endTime": "355.08502", "body": "So for example, repeated high alert states. We talked about this in a PTSD video recently about how the the mind and the body connect, sleep disruption, sympathetic nervous system activation. Over time, this can contribute to things like migraines, chronic pain syndromes, hypertension, right, high blood pressure, gastrointestinal disorders. These conditions may manifest immediately or they may not manifest immediately. K?" }, { "speaker": "Leah Bucholz", "startTime": "355.08502", "endTime": "373.43", "body": "They may develop as long term physiologic consequences of prolonged dysregulation. Latency does not equal absence. Right? A common misunderstanding is if if it didn't show up right away, it must not be related. But many medical conditions have latency periods." }, { "speaker": "Leah Bucholz", "startTime": "373.83", "endTime": "404.00003", "body": "Right? Examples outside the military context include things like post traumatic arthritis, certain autoimmune conditions, degenerative disc disease, even cardiovascular disease after chronic stress exposure, even toxin exposures. Path pathology can bring, can begin long before symptoms become severe enough to seek treatment. Symptom onset is not always the same as disease onset. The role of aging as a multiplier." }, { "speaker": "Leah Bucholz", "startTime": "404.40002", "endTime": "417.265", "body": "So here's another key concept to kinda just tuck in the back of your mind. Right? Aging does not always necessarily cause the problem. It can expose underlying vulnerability. Think of aging as a stress test." }, { "speaker": "Leah Bucholz", "startTime": "417.66498", "endTime": "439.535", "body": "It's a if a joint was previously injured, aging may reveal instability sooner. If discs were stressed repeatedly, aging may accelerate dehydration and collapse. If the nervous system was chronically activated, aging may reduce resilience. Age can amplify prior stress. It doesn't always create the issue from nothing." }, { "speaker": "Leah Bucholz", "startTime": "440.01498", "endTime": "463.48502", "body": "So what what do clinicians consider? When evaluating delayed symptom onset, clinicians should look at things like prior injury documentation, occupation, or mechanical exposures, imaging patterns, although imaging does not always align. K? Timeline of progression, compensatory mechanics, risk factor burden. K?" }, { "speaker": "Leah Bucholz", "startTime": "463.48502", "endTime": "472.92502", "body": "Things like obesity. Right? It's rarely one factor alone. It's pattern recognition. So medicine evaluates plausibility, not just timing." }, { "speaker": "Leah Bucholz", "startTime": "473.64502", "endTime": "485.84", "body": "So it's an important balance. So staying grounded, you know, not every condition that appears later in life is related to service. It's it's just not. Some are, some are not. Degeneration is common." }, { "speaker": "Leah Bucholz", "startTime": "485.84", "endTime": "506.33", "body": "Chronic disease is multifactorial, but delayed onset alone does not rule out a connection. The key is whether there is a medically reasonable mechanism linking earlier exposure pathology to later pathology. That requires individualized analysis. It's not just you can't just look at this in just one frame. K?" }, { "speaker": "Leah Bucholz", "startTime": "506.33", "endTime": "521.71497", "body": "It's multifactorial. Even examiners, I review C and P exams quite a bit, and it's it seems like some of them don't really look at it in in this global way. It's it's not always black and white. So there's no blanket rule. So the final takeaway for you guys is that the body is resilient." }, { "speaker": "Leah Bucholz", "startTime": "521.71497", "endTime": "536.72003", "body": "It compensates. It adapts. But over time, compensation can give way to degeneration. Symptoms appearing years later do not automatically mean that it has nothing to do with your earlier stress or your service. It means the process unfolded gradually." }, { "speaker": "Leah Bucholz", "startTime": "537.12006", "endTime": "563.44", "body": "Understanding that helps remove oversimplified assumptions about timing. So if you've ever wondered why something developed years after service, I hope this explanation gave you a little bit of clarity. The human body reflects both time and history, and sometimes history takes years to fully service. If this was helpful, please like and subscribe. I regularly break down these topics, these complex medical topics related to VA disability in an evidence based way." }, { "speaker": "Leah Bucholz", "startTime": "563.60004", "endTime": "572.635", "body": "So this, again, is for educational purposes and is not legal advice. And I will see you guys in the next video, and please drop some comments. Alright. Talk to y'all later. Bye." } ] }