Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

who's treating me?

hopeless-in-mnhhopeless-in-mn Posts: 206
edited 06/11/2012 - 8:42 AM in Lower Back Pain
ok, for those who do not know me, i am 39, and have had three lumbar decompressions ( laminectomy/disectomy) since 2001. the last one in 2006. I still remain with chronic herniations at l4-5 and l5-s1, and stenosis. yes the herniations encroach upon the nerve roots, which are impinged further with the stenosis.

currently, I have a PM clinic that does not believe in narcotic pain relief, and that I only see once every 4-6 months.

the surgeon that did the last 2 surgeries says there is "nothing more he can do for me".

neurologist did not see the impingment.--nothing he could do.

so I have seen a new spinal surgeon twice now. he has placed me in a tlso brace that i couldn't handle due to my body shape ( it won't stay in place)and now switched me to a corset type brace which I am to wear for a month to see how much it helps, and then possibly a discogram, or a lifetime of wearing the brace.

so, I qualified finaly for SSDI, and sent a form to the new surgeon to fill out to get some relief from student loans, and the nurse called me back to say "the dr cannot fill this out as he has only consulted with you, and is notactually treated you. he does not consider to be treating a patient until he does surgery on them."

---oh, and my primary care dr is actually a PA, and cannot fill out any such forms.

....so, sorry for the long post, but who the heck is treating me?



  • Hi there...I can't help with who's treating you.
    I would suspect the surgeon that did your last surgery and said "there's nothing more I can do for you" is the one that can complete the paperwork.

    That being said, it seems that you may not be out of options if a doctor won't complete the forms.

    The current surgeon seems like he is willing to try to help you. But I suspect you want to apply for the disability due to inability to work. So I can't help there.

    I just wanted to give you my thoughts...if you have a surgeon willing to help you,that's positive. In the meantime, I would leverage your doctor that was out of options to see if he'd fill out the paperwork. But do not be surprised if he doesn't. He may think there is hope but just might believe there is a better doctor for you out there.

    Good luck.
  • Just wanted to let you know that I am thinking of you and will send positive vibes your way.
    I just don't understand the American health care, it seems most doctors try to pass the buck every chance they get.
    It just not fair.
    Hang in there and don't give up,
  • Kylie -> Doctors in US do not pass the buck. Perhaps I'm a bit defensive of our system but I digress. The issue is that the insurance companies and doctors are both in business to make money but the doctors have high mal-practice concerns.

    The "new" surgeon is in no way obligated to complete disability paperwork. The new surgeon has only done a consult. He never treated the initial issue and as a consult, he cannot in good conscience, sign paperwork to say this person is disabled unless he can assure the government that there are no options for this patient. My guess is if Dawn agrees to be his patient and try the treatment options...and they fail, then this new surgeon can complete paperwork.

    The primary care physician is not a specialist. So even though this patient's PCP is a physician's assistant, I don't believe any PCP would complete paperwork to say the patient is disabled unless s/he specialized in that field to know whether or not the patient's health couldn't be improved.

    To me, the doctor that should sign the papework is the one that said "there is nothing more I can do for you".

    Dawn - have you spoken to the surgeon who turned you away b/c there was no other treatment? Or is it more that the surgeon offered treatment that you didn't want to pursue? I ask b/c that may be the issue. If that's the case, the doctor should still complete the paperwork for you b/c the surgical option might be very risky and still leave you disabled and bankrupt....and from there see if it goes through.

    I hope this helps.
  • Dawn...you pay for insurance coverage. Go pay the co-pay or whatever to get that appointment with the surgeon who is "out of options". Tell him you really appreciate the efforts he's made and while you are trying to find alternate help, you need his help with the disability paperwork.

    If he won't complete it, ask him for suggestions on who could complete it OR for another specialist that might have experience with an extreme complex case like yours.

    From there...I would contact your insurance company to tell them you are at a cross roads and can they help. I would also call your work's disability center to see if they can help.

    There are a few things here
    1 - the surgeon who is out of options is wrong in not filling out paperwork
    2 - the surgeon who is out of options feels there is something that can be done so won't fill out the paperwork but doesn't know who to refer you to
    3 - there is concern that there is not enough 'evidence' that your issue can't be fixed but if that's the case...your insurance needs to help you find someone like a PM specialist.

    Good luck. I think there's a disability section out here...I was reading through it and it doesn't seem like an easy process. Just for work disability, it isn't easy.
  • sorry if I ruffled your feathers, i've just read time and time again of how doctors "walk" away after one surgery or say the person should be fine because they can't see anything. I hear of all the hoops you have to jump through and it just makes me so mad for you all.
    As Australia has a tendency to follow America in it's "trends" i'm petrified our health care system will end up like yours.
    Here our GP is the one who writes those kinds of reports and deals with all the red tape, his word is taken over any other doctors as he know the person the best.
    Again didn't mean to offend, just feel frustrated for Dawn.
  • I'm not so easily offended. To be honest, our healthcare debate right now is quite scary to everyone. I didn't even know where you were from.

    I have found that what you mention does happen.
    My last doctor was fantastic but if he told me one more time "how gratifying the surgery" should have been, I think I might have hit him. But I politely encouraged him to send me for another MRI b/c 'Gratifying" was not how I'd describe how I felt.

    I still think he was a good surgeon but still learning the 'patient' side of things. His partner (who I wanted to use) was a far better "listener".

    My current surgeon wants to know of any and every pain I'm feeling. He actually spent time with me on the initial consult b/c he wanted to make sure I was finding the right 'long term' surgeon if needed. He told me how he approaches lumbar issues and even went as far as explaining how he did fusions even though he didn't feel it was necessary now for me. He told me he was going over it vs. ADR vs. alternate treatements because he felt it was important for us to build a relationship. So he's quite the opposite.

    No feathers ruffled (well, I guess they might have been reviewing my rsponse but all is good).

    I am not at all familiar with Australia's healthcare.
  • Dawn,

    What doctor was treating you for filing the SSDI? Whom said you were unable to work and that you were disabled. I would think whatever doctor was able to write that information should be able to fill those papers out for you. I know in order to qualify for SSDI you had to be under a doctors care and since you were just approved I would assume that doctor is still a treating doctor. The doctor who order the brace is a treating doctor by the standards as well. If it is a surgeon and you are not a candidate for surgery he may be electing not to treat you as a patient and referring you else where for treatment meaning your not a surgical candidate. But I would look at whomever did your SSDI paperwork and offered up medical information that you are disabled. Keep in mind that disability will review your case and being looking for treating doctors as the information that says you are still unable to work.
  • Dawn,
    We can all feel your frustration and pain.The spine is not a perfect science,thus a very difficult thing to treat and diagnosis.Most of us will keep trying-different doctors and treatments until everything is exhausted.I am exhausted-still looking for that magic bullet.We all have our own journey-I am still trying.Getting tired though.Look into every avenue of recovery you can.I have good insurance. I am in my third and final state,thinking that big cities will offer me a better source of recovery.I will prosper and accept what comes my way.We are all in different stages of this process,so listen to a variety of opinions-then trust yourself - then your doctors.The thing about fishing for answers-as with fish-you will eventually catch something you like. I can relate to the metaphor-eventually myself catches up with myself and reality sets in.Sometimes not an easy thing to face.Keep writing.It is very helpful.

  • the new surgeon (who says is only consulting) is the one that perscribed the braces.

    i believe that the approval for the SSDI finally came about due to the combination of pain management, pt, and the new surgeon that i had just seen. along with notes from a few other specialists along the way.

    i have not seen the old surgeon since december of 2008, and as i stated, that was for like 5 min. in the hospital.

    is it a matter of not wanting to say that at this time i am going to be totally disabled for the rest of my life?

    or is it just not wanting to give up on me yet?

  • Do you have lawyers that specialise in this sort of thing that perhaps guide you in the write direction?
    Just a thought, as obviously I have not a cluse as to how your system works.
  • Dawn,

    The new surgeon told you to wear the brace for a month and then see how it goes? So I would assume you will be following up with him? You mentioned about a discogram who would be ordering this test and getting the results? What I think you need to do is go back and see this surgeon and work out a action plan. surgeons are there to operate but a good surgeon will treat you and come up with a game plan. Most surgeons don't jump straight to surgery unless it is so severe that more damage could result in paralysis. They will look for conservative measures of treatment. For example I see a surgeon and I am not scheduled for surgery but needed something the other day and called and he ordered it for me. He is a treating physician, even though I don't have surgery scheduled with him. But I will be following up with him in about a month, as I can't just expect him to do things without seeing me either. Now if he just wrote a opinion for SSDI then he is not a treating physician but whomever is going to order that discogram and follow-up on the brace is the treating physician. Take the paperwork in with you when you follow-up with them on the brace.
  • Dawn...any update? Any luck with new surgeon and/or back brace?
  • sorry, but nothing new to report at this time...still have a couple of weeks to go with the brace, and as of now i'm leaning more to the it's not enough of a relief from the pain.

    --yes it helps, and at times, it drives me crazy too!


  • After dealing with my monthly visiter, and a few other major stressors lately, including 2 45 min. each way trips to visit someone in the hospital...one with and one without the brace......

    I have called the surgeons office and requested the discogram.

    The reasons for this are that even though I do get some pain relief with the brace, I do not feel that it is enough. Also, after a few hours of being in the brace, or doing activities in the brace (walking, cooking, cleaning) my legs and feet become more numb than if not wearing brace.

    So, it looks like I am back to my old question of pain, or numbness/lack of mobility?

    ---oh yeah, discogram is scheduled for april 5th.

  • it does help, and the original surgeon did not give any treatment plan, and in fact, would barely speak to me the last tome i saw him while admitted to the hospital for a massive pain flare with increasing numbness/incontiness issues. when i called the office to try and get the doctor to call me back to discuss treatment options, and his actions a the hospital, the nurse told me that i would have to schedule an office visit to see him.
    my issue with this, was why should my insurance have to pay for an office visit to get information fromthis doctor who could have taken the time to talk to me in the hospital in the first place instead of trying to run out of the room like his pants were on fire?!? (yes, he really did this!)

    so no, there is nothing that i won't follow other than a gastric bypass. (which has now been taken off the table)
    i have done injections, land therapy, pool therapy, chronic pain group therapy, many different combos of meds., nerve ablation, tens unit, more pt, more meds...and the circle/circus continues...

    yes, we often get the run around.
    a single mother of 4 children.
    -only 39, can't actually have this much pain...
    ....she must be faking...seeking attention...meds...
    ...something to this effect was actually noted i my chart by a dr at my clinic when i was desperate to be seen and my regular dr was unavailable!
    (subsequent mri showed the 2 very prominent herniations!)

    bottom line here....surgeon 1 doesn't have ability to do anything more, or doesn't want to deal with me any more (can't face his failures?)

    surgeon 2 isn't committed to operating yet...i do understand his hesitation...cleaning up after 3 failed back surgeries is daunting, and looking at up to a 4 level fusion.

    having difficulties finding adaquate pain relief in the era of no narcotics.

    ---the original form its self is not that big a deal...they will take 76 dollars of my ssdi check every month till i get it straightened out. but it is a hassle.
  • for the discogram. I hope it helps to solve the riddle.
    You're certainly having a rough time of it.
    I have two kids and I could NOT imagine looking after them on my own.
    My heart and my thoughts go out to you.
  • Did you get your paperwork filled out? I absolutely HATE that runaround. Part of the reason is that I think some doctors use "not the treating physician" to really mean "I don't think you need this," and I want an honest answer.

    When I was out on a health issue before, nobody wanted to fill out my disability paperwork, and they all claimed they weren't the treating physicians. The GP, the person who referred me to the specialist, and the specialist all shuffled me off. ARGH!.

    But I wonder if surgeon 2 has all of your old paperwork in the file. One thing you can't expect is them to fill out paperwork without all of the information they need.

    And you also need a new PM doctor who does meds. Just sayin'.
This discussion has been closed.
Sign In or Register to comment.