Thursday, February 5, 2015

I'm a Basket-Case: The Last of 3 Spinal Surgeons' visits

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So I have to start by of course saying a huge "thank you" to all who have been praying throughout the entire process. God has clearly guided us to one surgeon throughout this entire process, and I have had a peace even through the "not-so-great" visits that God had a purpose for the visit, not to mention that we explored all of the options.

Secondly, I wanted to thank my sweet friend Anna Keefe for spending literally a full 12 hour day on the road with me (not kidding). She was a great support throughout the entire process of sitting in the waiting room for so long, to the visit itself, to the support that was needed afterward, and then treated me to a great meal at Red Lobster afterward (which totally made the trip worthwhile! :) ).

Lastly, Rence's parents were a HUGE help in keeping the boys. We dropped them off at "MeMe & PaPa's" and they had a full day of non-stop fun. Ruth and Larry told me they thoroughly enjoyed it as well, but that "those boys had a lot of energy". And they sure were excited to be there. Thank you Ruth & Larry! You were an extraordinary help!
 
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THE VISIT:
 
Yesterday's visit was in Huntsville, AL. We are about 2 1/2 hours from Huntsville from our house. However, we had to go by Crossville to pick up Anna, which added 30 minutes, and Ruth & Larry's house to drop off the boys, which added about 30 minutes = 1 hour total extra. So now we were looking at a 3 1/2 hour commute, which was very accurate.

We arrived about 10 minutes prior to my appointment and signed in, filled out paper work, then waited for an hour and a half to be called back by a nurse. Once we were called back to the room, I was not asked to put on a gown or shorts so that he could see my SI joints better. X-rays were not ordered. So I just waited to see what would happen next.

The doctor sounded like a nice man with his other patients as I heard him talking through the thin walls. We waited about 30-40 minutes to see the doctor once we were in the room. Luckily, we were like giddy children staring down from the 5th story window, watching the hospital tram go back and forth and people-watching to pass the time. By this point, I was hurting terribly after the drive AND waiting for so long. It was a combination.

Finally, I hear the doctor pull the files from the door and begin to look at my never-ending pile of MRIs, CTs, and Xrays. He finally enters the room and introduces himself. He seemed nice enough. He asked what was going on, so I told him. He looked at my list of meds, and I've never gotten the reaction I did from this doctor by any other physician I've seen. He said, "Wow...you're on all of this? (he began listing the meds off one by one as I agreed and told him it barely touches the pain, but I have a pain doctor)." That statement made me think that he doesn't understand the severity of pain in so many patients today. It also told me that he didn't take the time to look at my medications list before he came in to see me.

I had brought my crutch (one) with me (although I really needed my wheelchair with how much pain I was in at that point). He asked me to walk to him, so I asked if he wanted me to use my crutch or walk without it. He said without, so I did...I explained that my walking gait is a lot worse without it and the crutch provides a lot more support and stability and pain management. He then asked me to get up on the table and sit up on the edge of it. He checked my reflexes, then crossed my legs and pushed slightly (not even a maneuver that's known to check for the SI - I believe it checks for damaged discs). And that was the END of my physical exam. Yes, the END. He never once touched or even looked at my back or SI joints.

Before I continue, remember that I've had 3 SI joint injections and 1 nerve ablation on the SI joint (all bilateral) under fluoroscopic (Xray) guidance (which is highly reliable in hitting the exact location of the SI joint). I have met all qualifications for surgery, even from my insurance's perspective.

So he then throws in that before we commit to doing an SI fusion, he would like me to undergo 2 more SI joint injections under CT. I asked him "why the CT? I already got 80% relief from the other 2, which shows via Xray that they got the right spot." He didn't completely answer the question, but said that "the CT guided SI injections provide relief 60-80% of the time. Then take into account that surgery is successful 60-80% of the time. So that knocks down my percentage tremendously of a successful surgery." I totally felt like that was a "I'm-gonna-throw-you-somethin'-and-see-if-it-sticks" kind of answer. And I totally didn't buy it. Not only that, but his statistics on surgery are SO much lower than SI-Bone's surgery statistics in their medical studies. I'm wondering if that is his "personal-best" - 60-80%, which IS scary. We later found out at the nurses desk that NOBODY does these CT injections anymore...the only doctor that did them quit a few years ago. He was asking me to do something that he doesn't normally ask his patients to do, or he would know that the task itself is not feasible.
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That wasn't it. His best curve-ball was yet to come. He then mentions that I need a psychiatric evaluation. Did you catch that? Yes, go clean up that drink you just spewed from your mouth and keep reading....a PSYCHIATRIC EVALUATION....one that we found out from the nurses that they have NEVER referred out for before (I burst into tears when they said nobody has ever been referred out for that before - up to that point, I thought this might be a normal thing). He said "I'm not calling you crazy or anything like that"....whatever...."but this evaluation will tell me how well you will do after spinal surgery." So basically, you're saying it's all in my head....or at least most of it, and that I am a total whimp. I am ready to be fighter after this surgery...with everything in me. Who wouldn't want to jump out of a body of pain if they were in my position? (By the way, I'm not against Psychiatric care at all, but the problem here is that he is basically saying that my pain is not real due to a psychiatric condition - that's where I have the problem.)

I didn't start letting it bother me until we got to the nurses desk to check out and found out about the legalities of getting the CT injections done and the Psych evaluation (which I was also pretty sure insurance wouldn't cover - and I was right). The nurses asked if I had any psychiatric problems, and I told them I simply have the basic depression that accompanies chronic pain, but it's very controlled with medication.

I then told them to forget about making appointments and I had another doctor who was much more caring and easy to work with who would do the surgery on both joints at the same time by spring break. The nurses were so kind and as I left I turned around and asked where I needed to pay for my copay. They said "we were just talking about that - don't you worry about that. We've got it taken care of. You do the best thing for you." I thanked them through the tears and we left. By the time we got the car, I already felt the peace of God overwhelm my heart. The tears were gone. Sure, I still feel annoyed and hurt by the doctor's words, but I forgive him. He's terribly young and doesn't "get it". I pray he does one day, but not through personal experience - through the eyes of his patients.

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Mental Illness and the Church