Tomorrow's Appointment....

[mary.mary]

So, tomorrow is the day that I meet with the Surgeon. I am hoping that I might be able to get some help with what sort of things I should be asking him. Is there ANYTHING that some of you from past experiences wish you had said, done etc??

I am REALLY nervous & scared but in a small way relieved to hopefully get some answers as to what is really going on with my situation.

I will make sure to check in and update you with what the surgeon says.

As ALWAYS, THANK YOU for the support!!

All the best,
Mary

[phylly]

Hi Mary,
Likely the Dr. will examine you and then order some tests like X-rays and MRI's before they can really diagnose your problem. He may want you to try some physical therapy and an anti-inflammatory medication to see if your back calms down without surgery. Even though you are miserable some back problems heal themselves without surgery. I hope that is the case with you.

Once you know exactly what the problem is you can probably ask tons of questions. I am sure others will chime in here. I am so sorry for your problems, you are certainly carrying a big load on your shoulders. I hope by now you have found some help in caring for your daughter. Good luck with your appointment tomorrow.
Phylly

[Terry Allen Blackburn]

mary:

I am glad that you are getting in to see the surgeon. It might be helpful to write out your questions tonight to be prepared. It is always after the appointment that we wish we had asked this or that. Write them down and come prepared. I am hopeful that he will have the answers for you in getting your spinal pain taken care of.

Good-luck and let us know how it goes.

Terry Newton

[mary.mary]

Well, ya see that's the problem, I don't KNOW what to ask him. All I can think of is....
a)what is this pain?
b)why is it happening?
c)how do we get rid of it?

There has to be other questions that I should be asking, no?? I am CLUELESS with all of this stuff!! I have been doing physio since December and it has done nothing but make me worse.

I am a shy person, hate people to see me in pain, and never know how to handle situations like this...

Does that sound strange??

[fuzzy]

Mary.mary:

Have you had a MRI scan yet?

If not then that will be important for the doctor to know what may be going on in your back.


Explain to the doc how you hurt, where you hurt and how long you have been hurting. If there are particular things about physio that made you hurt then tell him as that is important as well. If you have issues like numbness, pain down the legs etc make sure you mention all of this.

I seem to recall that you recently reinjured your back rather badly after having had problems for a while already. It is true that back injurys do heal and I have learned over the many years of having these problems that it takes time and that it is really easy to re injure by "making the wrong move". The Doc should order Xrays and MRIs. Try to be as relaxed as you can given all the pain you are in and don't worry about the xrays etc. These are good things, they are safe to do and will tell you wheather there is in fact something that should be worked on or if it is the kind of thing where it is worth to try and heal then rush to a surgery. Then you would want to give it a chance before doing a procedure. I waited literally 10 years. So explain really good what your problem is. If you can take someone with you who will also listen to what the doc says that can really help as when one is nervous you might only hear part of what the doctor says. Try to concentrate on what he says. Try to be composed. He is there to help you, gather as much information as possible. Your questions will come by themselves. Make sure you ask them as soon as they pop up in your mind.

Ask about MEDs! the doctors sometimes like to forget to write a script....

I am sure you will be ok and I hope you do get some meds written up to help with the pain. When I finally insisted on some they really did help me get moving again which over all helped my back heal up.

Good luck

[Maria]

Mary,

If you've not had films done yet or diagnostic testing it's more or less about presenting with your symptoms and the doctor telling you what he thinks it is but for anything that's continuing on and really bad pain that limits activity for anything beyond an acute flare up there should be more definitive diagnostics done with xray, MRI and so forth.


Have you had films done yet? I'm guessing so and if so then I always like my films reviewed with me as well as the report.

The thing I've noticed is that sometimes the doctor will go over the films very quickly and if the report isn't in my hands where I can read what it says I may not see something I want to ask to be further explained so that's why I like to see the report or review it with the doctor as well as the films.

Ask him to explain in easy to understand terminology and point out where he thinks the problems are and how they may have developed.

Ask him to explain what further tests he might do to rule out other potential pain generators or are there ones that might not show up on the tests he's ordered already.

Ask him to explain the proposed surgery (surgery he's suggesting) and what type of hardware he would use ie fusion - what type of cages, how many screws, rods etc... ADR what type of implant and/or hybrid surgery with fusion at one level and ADR at one or why would he consider fusion over ADR or vice versa.

Explain the surgery in terms of if it's global (anterior and posterior or anterior or posterior ?? incision/entry, what other structures are affected with this surgery anteriorly or posteriorly or both).

Ask if it's thought that the proposed surgery would affect the level above or below and/or weaken other segments, cause other problems.. more pain?

Ask him how many surgeries he's done like this before (esp. if ADR).

What the typical timeline is for recovery

Will you be able to take care of your daughter

What activities must you absolutely avoid post surgery (esp. as you're a single parent).

*** I always like to ask for copies of my films or at least the report of tests done.

As mentioned previously formulating the questions you want to ask the night before is most helpful to me and after the doctor is done examining me I tell him I have some very questions for him and go down my list to make it easier for him or her to answer but I try to get all my questions answered and write down anything important the doctor mentions that I can later look up.

This is pretty off the cuff and I apologize for not being more organized with what I'm stating.. I'm a bit tired as it was hot here all day and my back is hurting sitting while I type. Good luck!

[ans]

You have given sage advice from above. This is from the top of my head; as I'm beat, I'll probably reiterate w/is said.

Where are you? Maybe someone knows of some excellent doctors there?

Now you must learn to be your own advocate and be assertive. Always request doctors' records and keep your films (x-rays, MRI, or CT) at home in a safe place. You can get copies where you are imaged.

At minimum you need an MRI. Also (I only know about lumbar pain), flexion x-rays.

If your MRI doesn't show that you are at risk of spinal cord compression and/or Cauda Equina Syndrome (these may indicate you need surgery ASAP), your spine doc may prescribe physical therapy, an epidural/steroid localized injection, or other tests (like nerve testing if you have nerve pain/numbness).

It's standard that one gets about 3 opinions from excellent docs before going under the knife which is a big deal.

I'll try to find something specific about relevant questions to ask.

Best of luck to you. Sorry you're in this club. - Allan

[Maria]

Just like with my car when the repair person says "it's needs.." and I say "how long can xyz last w/o this repair?".. that's pretty much what I would ask the surgeon if he suggests surgery post MRI.

And then as ans mentioned I'd be sure to get at least one other surgical opinion, not from anyone in the same group, not from the first guy or gal that the surgeon might offer if you ask for 3 names and not from someone that only does fusion surgery if that's what your surgeon recommended but ADR is a possibility.

I skipped way ahead to surgery w/o mentioning any of the conservative treatments which would be physical therapy and epidural injections both of which helped me at differing times and BTW, from point of diagnosis for me to point of first surgery there was a 7 year in between time frame. After I had my 1rst spine surgery in '89, I had a 2nd in '92. By 1998 I was recommended to have another which I did not do (3 level global fusion) and then in 2003 was Ok'd for 2 level ADR trial (didn't do) and in 2006 a hybrid surgery with ADR at L4 and fusion at L5S1 was authorized and again - didn't do it.

I chose pain meds and epidurals because of the relief I get with these *so far* and because I don't want to be unavailable for my 87y.o. father who lives alone across country from me.. it's difficult to travel but so far I can do it and I pretty much know what shape I'm in now and I just want to leave things status quo for now.

Anyway, certain things necessitate surgery immediately and other things can wait or at least there can be a trial of conservative therapy and then if all of this fails one will progress on to surgery.

again good luck. I'm unable to sleep tonight so just thought I'd pop back in here...