Friday, January 30, 2015

A New Day and a New Path - Spinal Surgery Consults

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As many of you know (and had been faithfully & fervently praying over), I was scheduled for two spinal surgery consults in Georgia on Thursday and Friday - one in Gainesville and one in Cartersville.

A few people have been asking why Rence is unable to attend many of these visits with me. Rence is more than supportive with everything that is involved with my care. He was able to get off of work last minute this last time (thankfully). It is, however, very difficult for him to take days off because he doesn't get paid days off (and we're already running very short on money, which is why we try are trying to save his "off days" for surgery time - additional days off mean additional days without pay, which we may not be able to afford). In addition, it throws off the class's timeline in regards to accomplishing the AL state standards for college math, which is already difficult to fulfill in a semester when no classes are cancelled due to time constraints. I am so grateful for his never-ending support. If he could be there, he would. During the rare occasion when he's off and I have appointments, he usually goes with me (he works during the summer as well). And I can't say enough about those who can help fill the gap when Rence is unable to take off. We are so grateful to you all!

I need to also say a HUGE thank you to both my parents for sitting with the boys almost all day on Thursday and all morning on Friday. The boys were also sick this week (again - they started running a temp. the day we arrived at my parents' in Georgia), and Grandma and PaPa have handled it so well (of course they would - I had no doubts leaving them in the hands of two nurses who take good care their Grandbabies).

CARTERSVILLE, GA
Visit at Georgia Bone & Joint, Dr. Charles Cha (Friday morning, Jan. 30th):

Cartersville is fortunately very close from my parents' home in Georgia - only 25 minutes drive. It would be about 2 1/2 hours from our home in Alabama. We were very pleased with the friendliness of the staff and the nice facilities. They got me back fairly quickly. As most physician visits go, they took my vitals and paperwork and all of the test/scan reports & discs that I had. They then took me back to get another x-ray, although they didn't take but 3 angles/views. The nurse practitioner then came in to see me and get some basic information for Dr. Cha. She did a very simple exam on my SI joints ("does it hurt when I press here"). She tested reflexes and leg strength. Dr. Cha then came in, and I was very pleased with how personable he seemed. He did a very simple exam, but did do a few of the SI joint diagnostic manipulations. The majority of them were very painful. However, he came to the conclusion that I did not meet his criteria for surgery, which he said meant having pain for each of his tests performed, as well as taking into consideration the x-rays. He felt that the L3/4, L5/S1 was my primary area of pain and I was getting confused by the source of the pain. He was very nice about it all and answered all of our questions. Rence and I felt he was simply wanting a candidate that clearly met every criteria to the "T" for surgery. In other words, if it isn't "black and white", he feels uncomfortable proceeding. Rence and I were not discouraged one bit, but rather felt that God was helping point us even more clearly in the right direction.

Image found on www.meadowheadphysiotherapy.co.uk
GAINESVILLE, GA
Visit at Specialty Clinics of Georgia, Dr. David Weiss (Thursday afternoon, Jan. 29th):
Gainesville is about 4 1/2 hours (without traffic) from our home in Alabama, and about 2 1/2 hours from my parents' home in Georgia. Before we even left my parents' house, we felt at peace with what God had in store for us - even though we didn't know what that would be. My parents, Rence, myself and Gavin all gathered to pray for wisdom in all that was done and that the doctor would be understanding and compassionate.

We arrived right on time for my appointment. I was already impressed upon arrival. The facilities were set up very nicely, and the staff seemed friendly and personable. I had x-rays of my SI joint and lumbar done recently (on October 23, 2014), but they only did 2-3 angles/views of the joints/lumbar spine on the x-rays. This physician's office does them for every new patient and did approximately 15-20 different views and angles of the SI joint and lumbar spine. I then went in to the exam room with Dr. Weiss' nurse, who was extremely sweet and personal. Once she was done gathering her information, Dr. Weiss and his other nurse (one that takes charting notes during exam) came in to do the exam. Over the course of the entire exam, Dr. Weiss spent 45 minutes with us....yes, 45 minutes. I didn't feel rushed, and every question was answered. Part of the exam is a painful manipulation of the SI joints in all sorts of positions and with pressure on the joint. I felt like I was going to literally jump off the table for several of the manipulations he did. But I knew it was coming before he even came in the room, and it's worth it to get the answers you need. I asked Rence if enjoyed watching the Dr. "beat on me". ;) He giggled.

Not once during the visit did I feel nervous or anxious. I knew God had this under control. I didn't know how it was all going to play out, but God's peace surpassed my understanding....I love it when He does that! *sigh*

After Dr. Weiss finished his exam, he sat down and explained that he takes everything into account, but especially the physical examination. He said he doesn't go solely by x-rays (I knew at that point we were in the right place...). He then said he felt that I was a perfect candidate for surgery. Dr. Weiss felt there were a few things we needed to know before making a major decision:
  • By evidence of my physical reactions from the manipulations during Dr. Weiss' exam and from looking at my description of symptoms (including burning pain, numbness and tingling down the legs), he felt that it was extremely likely that I have piriformis syndrome. He explained that one of the manipulations he performed is solely for diagnosing piriformis syndrome, which I was positively responsive to (meaning I showed signs of piriformis syndrome). In order to absolutely diagnose, we will need to see a physician in Atlanta in February for another EMG/NCV. This time, however, the EMG/NCV will test specifically for piriformis syndrome, which the prior EMG/NCV (done in November) did not test for. If it is diagnosed, it is an easy fix through surgery and can be done at the same time as SI fusion surgery.
  • Secondly, Dr. Weiss discussed the difference between using the I-fuse system (through SI bone) and basic screws. The I-fuse system uses a type of triangular pin that is placed in the SI joint and the bone actually fuses to the pin over time. Screws, however, are made of material that is unable to be fused to the bone. Also, the I-fuse system seems to work extremely well on middle aged and older patients, since the objective is for the pins to create a complete fusion and no movement in the joint whatsoever. The screws, however, do allow for just a slight bit of movement, therefore minimizing the stress on other joints following the fusion. For this reason, screws in the SI joint are recommended for patients of younger ages (under 40).
So...we believe we have found the surgeon God has been preparing us for. We felt such a peace about this entire visit. He seemed so knowledgeable, compassionate and well-balanced in how he received evidence of injury. We are leaning toward using screws, and we are waiting for the call from his nurse to schedule the date of surgery for the Thursday before Spring Break, as well as to schedule the EMG/NCV with the physician in Atlanta for February.

HUNTSVILLE, AL
(February 4, 2015)

I'm still feeling very led toward Dr. Weiss for surgery. However, I have one more consult in Huntsville. I am debating slightly about still going, but am leaning toward keeping the appointment just to get one more opinion on my lumbar spine, especially. Stay tuned for updates!

Monday, January 26, 2015

Search for a Spinal Surgeon (Again), Week 1


Image from www.joyful-expression.blogspot.com
 So I've had a few weeks to recover from the big blow I took from my previous surgeon, being told at the 2nd visit that I was fine and he never said he'd do surgery (all of this is contrary to his notes, which I have in my personal records now and will be making a complaint using this evidence). We had been preparing for this since October 22nd and we were so extremely excited. January 9th was "dooms day" (our last appointment) with this previous surgeon, and the day I began the search for a new one.

Now that we are up to speed, I can tell you that God and I have been growing ever closer through this entire mess. That's the way it always seems to work, which is a beautiful thing - he can use something so broken and painful and turn it into something to glorify himself. I have prayed so fervently for the provision of a surgeon (among the 3 I will see between Jan. 29 and Feb. 4) who is skilled, compassionate and wise. I have prayed that these doctors do not simply look at the paperwork (as most doctors do and stop at this point), but that they also use my experiences with my pain and lack of mobility (and listen compassionately), as well as the use of examination, in order to come to a conclusion as to whether or not they feel they can help me. I'm praying for my anxiety to be calmed, as I've felt more anxious and depressed lately than usual (I struggle with chronic chemical depression, which is normally controlled very well with anti-depressants and supplements for my adrenal fatigue, but I still have episodes once every blue moon that it rears it's ugly head.). I do have that peace that God is with me, no matter what depth the water I tread. I also have peace that God has set aside one of these three physicians to guide me to the right help, whether that be surgery or another physician or surgeon.

What I'm asking from my precious friends & family are for prayers on these days and especially at these times below:


January 29th, 3:30 pm - Appointment in Gainesville, GA
January 30th, 9:00 am - Appointment in Cartersville, GA
February 4th, 1:30 pm - Appointment in Huntsville, AL

James 5:16
Therefore confess your sins to each other and pray for each other so that you may be healed. The prayer of a righteous person is powerful and effective.

Thursday, January 15, 2015

The Hands and Feet of Christ

Today, I'm still overwhelmed by God's provision that took place last night. There is never a need that goes unprovided for. But we never know how that provision will take place...we simply trust, give as He commands and with a cheerful heart, and He provides. The need never, ever goes unprovided for.

With everything going on regarding my previous surgeon suddenly dropping the ball and leaving me to pick up the pieces and in quite a hurry, I had to schedule 3 surgeon appointments for consults that are all the way in Cummings, AL, Huntsville, AL, and Gainesville, GA. All of those appointments cost $40 for the consult, $60 to see the new physician (one time fee for each new physician seen required by insurance), and a $125 administrative fee for the Gainesville physician to look over my previous files.

Normally, we would be able to pay those bills and simply be on a "tight" budget for the rest of the month. This is due to my disability check (although a small amount of $450, you can see how large a part it can play in a month such as this). We are expecting it very soon. However, it won't be in soon enough for my appointments. As a matter of fact, the payment has been delayed over 60 days beyond what my attorney was expecting. So, we are running $200 short this month.

I mentioned the recent situation about the previous surgeon and needing to find a new one quickly to the sweet choir at FBC Oxford, and I also mentioned briefly to pray for provision due to the prospected accumulation of the medical bills. The director, Justin Holland, closed us out in prayer, praying for each request specifically. As Justin was about to close us out in prayer, a sweet member of our choir stood up and simply said "I'm going to put a basket by the door. If you feel led, let's each give a little to help one of our own when it's needed." I couldn't hold back the emotions...and all night, they kept coming. And guess what...I'm still cryin' like a baby. Do you remember the need? The need ($200) was met +$6 in addition to several gift cards.

Praise Jehovah Jireh - He is our Provider!

Philippians 4:19 
And my God will meet all your needs
according to the riches of his glory in Christ Jesus.


If you were one who generously gave, Rence and I can't tell you how moved we are by your humble act of servitude and your overwhelming generosity. FBC Oxford stands out in such a positive and Christ-like manner fluently, but also by stepping up to serve our community. We can't even begin to tell you how humbled we are that we can spend time on mission and in worship with such an amazing group of Christ-followers who clearly follow the leading of the Holy Spirit.

With love, thanks, and praise to God!
The Cochrans

Sunday, January 11, 2015

Where Do We Go From Here? - Surgeon's Visit Summary

Please keep me and your family in your prayers. The doctor/surgeon's visit was a train wreck. Before you begin reading my novel about my roller-coaster of a day, let me say that I have the best support system possible. I always have several people willing to attend these appointments with me, and those that don't attend back me up in prayer.

Thank you Lauree Hatcher for being my sweet friend and support, and willing to speak up for me at this unexpected turn in the road. Thank you to my parents for listening to my story when I got home, understanding my situation, and being there when I felt like crying it out, but also encouraging me along the way. And thank you specifically to Ashley Smith, whom I was able to call and talk with and ask for prayer. Thank you for praying for me on the spot, over the phone. And, of course, I can't go without thanking my awesome husband, who is always there for me and goes through so much. We've been down similar roads before, and he's always stood strong. On this earth (secondary to my Savior), he is my rock.

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So, we begin the story:

The "doctor/surgeon" didn't even remember seeing me before OR telling me he would do surgery - of which I have documentation and they have the x-rays on file that were taken last time I went, which showed my SI joints in "fairly rough shape". I asked him if we could look at them again. Over and over he said "no". I kept telling him what he said about those Xrays last time. He simply proved that he had doubts about his argument, because he would simply be proving himself right if he really believed himself. If he was wrong however, he would deny that we can view them. He denied over 3 times.

I was told that his experience of 20 years meant that I am not remembering correctly and that he never would have promised to do surgery on me. I was further told by this "doctor" that there is no "medical" reason I should be in a wheelchair (I use it for the lowering of pain levels and ease of mobility, and it is prescribed by my pain doctor). If that's not a shocker, Lauree (my sweet friend & support buddy) then asked "well, if this were your daughter and she were in the same situation, what would you say or do with her?" Thinking we might get an empathetic response out of him at that point (which was a stupid thought, looking back), he said "I would tell her to move forward and get off the narcotics" (he later said we "trapped" him into that statement, and he was "sorry he didn't see the trap coming"). Wow. No surgery...I've tried every means available to me to reduce the pain, which none have worked (all were documented and provided to him). And there is such a thing called "opioid dependence" - something most doctors are very aware of. It is very different from addiction. Is he really that ignorant or that unsympathetic, or both? I vote for the latter.
  • He told me I had no spinal stenosis. I pointed out where I did. He then said "well, that's mild". I have a record where it says "moderate spinal stenosis". At my last visit with him, I was actually told that my Xray showed "moderate to fairly severe" spinal stenosis on the L5/S1. Once again - no records written/recorded by him, and no memory or willingness to trust that what I was saying had any weight to it (which the Xrays would have proven).
  • He told me on the MRI (before we found out he had no memory of surgery) that I had nerve impingement on the L5/S1 (which was also found on the nerve conduction study & electromyography). He then turned around and said I would have to have nerve impingement in order to do surgery, which I "didn't have". I mentioned what he said regarding the MRI. He said he never said that.
  • He said there is no kind of surgery at all to help me. He also said there is not a surgery for a herniated disc. I told him there is, because my dad just had one.
  • I told him about us signing papers on my first visit on 10-22-14 to start the advocate program for the SI-joint fusion procedure to be covered by insurance (through I-fuse bone). He said that's not in my file and he's never seen that. I told him that the process is almost finished and I will be covered on 1-15 because of his medical opinion being written in the findings and being submitted into the advocate program. He then told us that he figured that I had contacted his office on my own accord and told them that the he. said I needed surgery, so they took my word for it and started the process. I then pulled out my handy-dandy paperwork and showed him where he started everything on 10-22 and SIGNED the paperwork. He had no words (this was after I called the manager in).
  • When I asked him why he thinks I drove 3 hours to come see him if I didn't think I was having surgery, he responded "you came to get the test results" - I educated him that I have had these conditions for 13 years now, and I myself can fairly accurately read an MRI of the spine/lumbar, and I especially know exactly how to read an MRI report, all of which I provided him with. Furthermore, I gave him the results to the EMG/NCV (which I know how to read), and the bone scan. He said "I'll give you gas money, but I'm not going to cut on you." I later asked for the gas money that he offered. The manager then said he had conveniently left the office. She could not pay all of the gas money - it is 120 miles one way for each trip (I had made 2). She could provide me with $30 (10 gallons worth - it takes 18 gallons to get me there and back) from her own pocket. I thanked her. She kindly took the fee off for the office visit as well.
There is probably much more that I haven't even covered yet. The more I think about the whole thing, the more I remember what he said that qualifies as "ridiculous" and points to the fact that this man has a pattern - he has now treated both my mother and myself in this fashion, and I dare say we are not the first patients to be treated with such lack of respect. I remember telling him at one point that I'm "done with him", but I highly suggest he NEVER say to another patient that they should simply "come off their narcotics" and that they have "no medical reason to be in a wheelchair" (which is prescribed to me by another doctor - one I see monthly - and he says this despite all my 15 diagnoses that I gave him records of. If he had all the diagnoses I do, I would be interested to see his reaction to the pain, which I would never wish on my worst enemy.). I will be contacting the Georgia Board of Physicians and giving them every detail, including all of my records.

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There's no hiding the fact that I am upset, and that I was so hopeful that surgery would help things. I have many mixed emotions....I feel like this "doctor/surgeon" is not suited to practice medicine (no matter how skilled his hands are) so long as he continues to give false hope to those who need it so badly, only to go far beyond insult and emotionally and verbally degrade these people that deserve so much more, not to mention these patients he mistreats provide him with a living despite how he treats them.

Then there's another set of emotions. I'm obviously "down" right now. I talk about this and I cry before I even start the story. But I have so much faith that God is already working through this. I am glad that I now know this man's demeanor, for I would never want someone so cold cutting on me. But I have so much faith that God is already working through this. I told Lauree (my sweet friend and support person) that very thing in the exam room through tears - "I know God has a plan through this, but it's so hard to swallow sometimes." How does his plan play into all of this? I don't know. Maybe I never will. Maybe on the contrary. Maybe God is showing me something. I can already say that I am assessing something from all of this - maybe I put too much hope in the hands of man, not God. Maybe God has plans for me through this broken body. I've seen it happen & I can't describe the privilege and joy that comes from ministering to those with chronic illness. It's hard for me at times to not be able to see God's plans displayed on a projector and mapped out. But that's what makes our trust all-the-more strong and our bond with Christ even closer.

One of my favorite verses that speaks so loudly at this time is Romans 8:28:

Romans 8:28
And we know that in all things God works for the good of those who love him,
who have been called according to his purpose.

Psalm 27:14
Wait for the Lord; be strong and take heart and wait for the Lord.

Psalm 18:6, 16, 18, 28-29, 30b, 32b 
In my distress I called to the Lord; I cried to my God for help. He heard my voice. He drew me out of deep waters, [the enemies] confronted me in the day of disaster, but the Lord was my support. You, Lord, keep my lamp burning; my God turns my darkness into light. With your help I can advance against a troop; with my God I can scale a wall. He shields all who take refuge in him. It is God who arms me with strength.



See this flower in the picture? I can see myself in it. How?

I found this beautiful, yet unique flower in my back yard. And I can say that we bonded a bit. There's a reason. Look at the soil around the flower. How could anything grow in that? It's rocky and dry. The soil itself is not the type of soil you would use to plant seeds, greenery, or flowers (it doesn't look fertile). The flower seems to take on many trials in the light of day. But how does the flower stand proud and strong? The flower can be as strong as any flower so long as the roots are strong and in the right nutrients. On the inside (under the surface), the flower is safe. It has bloomed with confidence & beauty.

We have the ability to be the exact same way. The world can be brutal. We may have been planted in some rough circumstances. But God offers rich, fertile soil to plant our lives in, therefore making Him the foundation of our lives. When the strong storms come (and we must prepare before they come), the roots must be strong and deep in order for us to not "blow over" from the strong winds and rain. We have the ability to be just as beautifully unique and blossom in Christ's strength, hope, glory, purpose, and so much more. We will stand tall, proud and strong in His foundation of love, grace, and mercy, even through the most difficult of circumstances.



Colossians 2:6-7
Therefore as you have received Christ Jesus the Lord, so walk in Him, having been firmly rooted and now being built up in Him and established in your faith, just as you were instructed, and overflowing with gratitude.


Ephesians 3:16-19

...That Christ may dwell in your hearts through faith; that you, being rooted and grounded in love, may be able to comprehend with all the saints what is the width and length and depth and height—to know the love of Christ which passes knowledge; that you may be filled with all the fullness of God.

Jeremiah 17:7-8
Blessed is the man who trusts in the Lord, whose trust is the Lord. He is like a tree planted by water, that sends out its roots by the stream, and does not fear when heat comes, for its leaves remain green, and is not anxious in the year of drought, for it does not cease to bear fruit.


So where do we go from here? 

I need spinal surgery. There is no doubt about it. I had a list in my medical folder (I am very, very organized) of physicians/surgeons that are within "reach" (even though it might be as far as Gainesville, GA) that perform the specialized procedure of the SI joint fusions using the I-fuse system. Preferably, I'd like to find a physician that does this procedure (a type of spinal fusion) as well as other types of spinal surgery. So, as Lauree and I de-stressed with Starbucks coffee after my "visit" (what better way?), I took advantage of the time and called several surgeons on my list that I was interested in - the total comes to 4 physicians/surgeons. Two of those offices were closed for Friday. I was able to make appointments with the other two.

I now have an appointment with one of the top-surgeons for this procedure in Gainesville, GA (about a 4 1/2 - 5 hour drive from where we live) on January 28. This doctor/surgeon requires an additional $125 administration fee to look over all previous files, as well as a visit prior to or following the initial visit to see the physical therapist and see where the joint is positioned the best (another inconvenience, but possibly worth it for a good surgeon). This physical therapist is one that attends surgeries with the physician and helps place the joints exactly where they need to be before they are fused. He does not, however, do other spinal surgeries. There is a possibility I will reschedule this one to be after the Huntsville/Feb. 4th visit. As I mentioned, the other one is for February 4th in Huntsville, also a surgeon that specializes in the procedure, but he also does other spinal surgeries.

How can you pray?
  • Please pray for wisdom in our decision making process. Pray that we are sensitive to the Holy Spirit's leading prior, during and after all of these visits.
  • Pray for healing to take place regarding the previous surgeon that treated me so poorly. Forgiveness sometimes takes time, and I believe this might be the case here, but I want to strive for forgiveness every single day.
  • Pray for pain relief until we find more options. Some days are really difficult. Some days are really good. Chronic pain is unpredictable.
  • Pray for open doors, if this be God's will for us.
  • Pray for Rence's job situation to be forgiving of days off, if need be. It's near impossible right now for him to miss a day, which is why we are looking to have all of this done be Spring Break (March 23rd).
  • Pray for the I-fuse bone advocacy program to continue to clear my case, and the previous doctor/surgeon to not intervene in any way. This will allow for a quicker surgery date, since I am cleared through insurance.
  • Pray for comfort & peace from God alone for our family in the meantime. He is our hope and strength, and our trust is in Him. He will provide a way when there seems to be no way. He is our deliverer, and He lights my path in the darkness so that I can continue to walk in His strength and purpose day by day.

Mental Illness and the Church