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Asking for 4th referral for an Orthopedic Surgeon-updated

charryccharry Posts: 5,657
edited 06/11/2012 - 8:44 AM in Degenerative Disc Disease
I went to my Dr. to get a referral to my 4th Orthosurgeon in 2 years and 3 months and she was really annoyed that I wanted another referral after 3 Surgeons have already told me no to surgery. I said well it's been over 2 years and tried all conservative treatments I thought I would get another opinion. She says well usually that's why there's pain Management Drs for people who don't qualify for surgery.

I bet if it were her in pain 24/7 she would have lots of opinions..Just needed to vent as this bothers me. She says usually people only have 2 opinions but you've had 3 already. This is the last one I said fine. She said Surgeons are so busy and have to review all your tests etc. and lots of people haven't even had their first opinion and they have to wait.

I said so in my case now I have to collect my reduced work pension and Government pension plan now at 50?
I was lucky to see 3 of course after long waits and the first 2 Orthos I went to was examined by the fellow and not the Surgeon I waited so long to see and the next gently touched my back and asked"Do you feel pain here?" No other exams. The Neurosurgeon was okay but still disappointed with his exam, reading paperwork instead of looking at the films. I give way better exams then the Docs I've seen so far.The new Ortho I'm seeing did surgery on a friend just shaved the discs with spurs and minor disc problem and he's normal working and that now. I'll stop the referrals after seeing him.

I've heard after all conservative measures are tried and the pain is keeping you from working or doing normal things you should get help. Now feel like blah of course I don't want to take up the Surgeon's time when there's others out there who are waiting to see a Dr. Thanks if you got this far reading. Charry
DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN


  • You shouldn't question yourself over your motive or your need for another opinion. It's your body and you are the one stuck with it, not your doc who's being difficult. If we don't advocate for ourselves, no one else is.

    I hope you succeed in getting this other surgeon to give you his opinion.

    Best wishes,

  • i agree with C get as many opinions as you can .you know yourself that one surgeon opinion can be totally different to anothers .i got 4 opinions in my back 3 surgeons told me that they could do nothing .but i found someone that is willing to try something as staying as i am in not an option good luck
  • What happened to compassion and caring in doctors?? How dare she try to make you feel guilty?

    You have a right to good care. I would start preparing now for this doctors appt. Make a list of all your treatments and tests. Keep a detailed pain log. And make a list of questions. And please please take someone with a big mouth with you!!

  • Hi Charry,

    I agree w/ all of the above and if I were in your shoes, I would 'fire' the doctor that's annoyed at your quest in trying to get resolution to the pain you've experienced for so long. What quality of life does a person have when pain is their constant 'companion'?

    IMHO, any MD that's worth their salt has some degree of compassion for what their patients are dealing with and would work with them to get to the bottom of what the issues are. Can your insurance comp. give you referral for another PM doc? Perhaps a new set of eyes can help you find the solution you deserve. I hope the new ortho appointment goes well, please keep us posted.


  • Hi Charry,
    I've been in your shoes. What am I saying? I am in your shoes. My last visit when I asked for a referral to a particular surgeon my doctor said, "Ok but after this we are done." Oh, I don't think so. As long as I think there is something that can be done I will keep on seeking.

    Now don't get me wrong. I get to the point where I say, "Whatever, I give up." But then I pout for a bit and then pick myself back up and go at it again." I know it's hard.

    It's your body. You call the shots. Besides, they are getting paid very well for their time.

    Hang in there!
  • Howdy Charry,

    I think I would switch Doctors if mine had her attitude - what am I saying, hehe, I just fired on for being a &*&^ <-- Insert your favorite word!

    Frog is right, our bodies *know* a lot more than our minds do! I would stick to my guns if I were you Charry. Forget 'Miss attitude' and go forth and prosper. :)

    This is one of those cases I wish we could transfer our symptoms to said doctor for 24 hours and see what they think about it then, then remind them 'try it for 24/7.' I think from what I've read of your posts, you've probably gone through *more* conservative treatments than a lot of us! You go girl!!! Support *HUGZ*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Uh, did you ask to see the surgeon for free? Are we on health care rationing? Why are all those other people waiting, maybe she should refer them too?

    It seems that when I call a surgeon and ask for an appointment, they don't cancel someone else's appointment to give me one. It's not like every time you see a surgeon, a child starves to death in Africa.

    I think you need a new PCP.

  • That is so shocking! Thanks for answering. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • She is my Primary GP Dr. I've had for almost 20 years and she gives my meds. My PM Dr. only gives injections. This Surgeon may say no to surgery but I feel like I need to see him. I never heard her be like this before! I used to go for flu shot and I would give her one too! Guess I caught her at the wrong moment! I thought I was 'just' in asking thanks. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Give her the benefit of the doubt. THere are many people out there who are abusing medical care. Some have a psychological high from seeing doctors which is a waste of medical resources and insurance dollars. Some are using the doctors to get pain meds (not your case in England which seems like a great idea having one doc prescribe). And some won't follow the doctors orders and keep going back with excuses. And then there are the ones who are using doctors to play the system and stay on disability.

    I don't think you should give up. Maybe you need to put together a comparison of what each doctor has said and see if you can find any similarities. Another thought is that as a nurse you may be filtering what you tell the doctors unintentionally. Put everything down on paper. What you've tried, what worked, etc. Hopefully this surgeon will see something the others didn't.
  • Hey Charry,

    I think you are justified in asking for another referral. I know things work differently with your healthcare. But, I cannot see why there are no other options for you. Doing the conservative treatments for 2 yrs is a long time. I hope the new Surgeon has some new ideas.

    Maybe your GP was just having a bad day. If she objects in the future, I would have to find out why.

  • hi charry
    If my pcp told me that i would have told him off good...Shame on that doc for saying that to you...
    You are entitled to all the opinions you want.
    Please tell me your not going back to that doc.
    you vent all you need to.
    You been going thru alot and if you want to see 50 diff docs you should till your comfortable with one and you get help needed..
    I hope you find one that listens and can get you some answers and relief...
    good luck
    neck,bone spurs pain started 04, back issues and fusion l4,l5 06~hardware removed.
    good few yrs. 09 pain sharp, numbness feet,legs, diagnosed fibro, neurop. legs.lung issues.
    daily goal do good thing for someone.
  • I see how kind and patient you have been with your drs and treatment plans. Always giving them the benefit of the doubt and trying everything they suggest. Please don't feel guilty, you deserve as many drs as you want and until you get an answer that you can live with, All you want is for your pain to be tolerable and life better, you deserve that! How many times does one dr say no and another comes along, or your pain,mri changes and then they advise surgery or treatment and all the sudden the person is better, you've seen that on here many times! Don't give up or give in~ Be your own advocate and go get 'em!

    Just food for thought~ I sometimes think when a dr says you are fine, or no surgery, mri,etc is ok,it's not that bad, etc.....Then you take your records with those comments included with you and they follow you. Many drs are funny about over riding each other, even if they never met, it's like some silent code or something. I have stories about that but not now.

    But anyway, I remember you live in Canada so I don't know if this is possible but can you try to find a dr w/o a referral and have new tests,start over or something? Actually, I think going to a dr that you know was successful is a great start because you can praise his work and how you feel confident in his diagnoses knowing that and then see what happens- I wish you the best of luck with this dr! I'm glad you are getting to see him but please don't give up and let it be the last choice ever if you are still not happy!

    Take care!
  • You know, I have another angle to approach it from. Things change. How long ago was the first surgeon visit? Maybe you weren't a candidate for surgery then, but that doesn't mean you aren't now?

    DDD is degenerative. It degenerates. Things get worse every day. Not in the way of, say, MS, but there are definitely changes over months and years.

    Not only that, but surgical techniques and research changes, and opinions regarding who are the best candidates change.

    So, indeed, if over the years you still have pain, I can't imagine it doesn't behoove you to keep asking the question. I think your doctor is plain out wrong. I know you've been seeing her for 20 years, but do you really want to be seeing someone who has such a wrongheaded notion on something so important?

  • Since you live in Canada and have national healthcare. It sounds like you already got more than is typical by having 3 opinions.

    Don't you also have the option to get another opinion if you pay out of pocket? Can't you get additional private insurance?

    A lot of people here assume you are in the US with private healthcare.
  • :D
    I support you 100%! As long as we are breathing and on this earth, I would continue to look for an answer to my health issue to have a better quality of life.

    Don't let negative comments from other people get you down -- You're not crazy in trying to get to the root of your problem.

    Yours in fighting for the right to feel good!

  • Well yes we are the ones who keep those darn surgeons in business. That's why they went to medical school, so they could see patients review files, read films, order tests, help people etc etc etc. I would dump that doc like a hot potato if she pulls that attitude again. They work for us the patient and they are there to help us the patient!! I wish you luck with your new appointment. And besides it has been two years it would probably be good to check up on things.
  • All 3 Surgeons I've seen and my Primary GP Dr. says they don't do surgery just for pain but this article on here says the following. Still awaiting my 4th opinion Orthosurgeon.

    For people with ongoing severe, disabling pain and associated symptoms (e.g., numbness, tingling, difficulty sitting) it is sometimes not possible to wait for non-surgical therapy to work and/or for nature to run its course. Consequently, surgery - either the more standard fusion surgery or the newer artificial disc replacement surgery - may be warranted if patients meet the following criteria:They have conscientiously engaged in at least six months of non-surgical pain treatment and active exercise-based physical rehabilitation for core strengthening;

    Their pain is still significant, both in terms of magnitude and its inability to be controlled with acceptable doses of medication or treatment, and, most importantly;

    Their ability to function in every day activities is seriously diminished. Patients may be advised to apply “the every day test”.

    This means that if they are making concessions to their normal lifestyle every day of their lives because of their back pain, despite adequate non-operative treatments, then a surgical consultation is appropriate.
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Howdy Charry,

    Sorry to hear you still don't have answers to give you true relief of your pain. My C5/6 had the hernia on the cord, but really for me, the pain (and my NS agreed) had gotten to the point I could barely function! The pain slowly escalated over a 2 year period, but the last say 3 months, debilitating.

    My NS did the surgery for 2 reasons. The hernia on the cord was getting larger, but more so my quality of life was S$%^, so we agreed to the surgery. My goodness, I think you have been in pain long enough that the would consider surgery? I will send you positive energy in the hopes that a surgeon can SEE that you need to have intervention via their skills! Wishing positive energy for your next consult. *HUG*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • With all of the advances in modern medicine, I think you should never give up seeking other opinions. Just as our pain is different, so are doctors and their skill, knowledge, and experience. One day you may just run across that doctor who had the solution to your problem. Doctors continue their training, just as we nurses do. With neurosurgeons and orthopedic doctors they are continually going to conferences and being offered new and better ways to treat their patients.

    Hopefully in your quest to find help you will stumble upon a doctor who has recently been trained, or at least made aware of, some new and improved technique/technology that just so happens to solve your problem. It's 2010 for goodness sake!

    Wishing you and everyone here the very best!
  • Charry;
    Pardon me for asking I've been reading your story so sorry for all you are going thru.My question is did you 1st MRI show you had a L5-s1 herinated Disk with an Annular tear and your 2nd MRI did not show this ?Also which area gives you more pain if you had to choose the Cervical or the Lumbar?When it comes to Surgery doctors to have to prove to the Insurance Companies much evidence warranting surgery. I know pain as long as you have had it should be enough to get some kind of relief plan started.Hope you can find the answers your looking for.I have been in that same boat as well. I traveled all over the states trying to find a doctor to help me.And eventually it paid off.You have to keep turning over every stone until you find what your looking for.Good Luck. >:D<
  • Yes my herniated disc was not seen in my second MRI. Instead it showed Degenerative disc disease throughout my lumbar spine. But have the same pain as I had with the herniated disc. I have decreased height in L1-2 and hyper-flavum ligament issues. my PM Dr. says there's nerve issues because of foot numbness. My lumbar issues are major in comparison with my neck and arm pain.

    It may seem it's minor due to the MRI showing only mild DDD but it's disabling. I'm still awaiting my 4th referral. Sorry you had to go to so many Surgeons to get help. Thanks everyone. Charry

    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • It's such a sad and frustrating place to be. You have done everything you can regarding conservative treatment options.

    I've read many, many posts hear and you, Charry, are one of the most positive people I've ever encountered. That positivity does a lot for our emotional well being, and in turn how we sometimes perceive our physical well being. But my goodness! How much is one person expected to endure before before somebody will see the big picture.

    It seems like the doctors are not putting the peices together. They shouldn't base their decision to not perform the surgery because of the MRI results. An MRI is just one component of the overall picture. They are a wonderful tool, but they are not the end all and be all.

    Have you had any other testing beside MRIs? I'm relatively new to the forum and still trying to read everything and learn about everyone and their situations. I am finding so many useful ideas and commonalities with other members. And it is a great way to spend my time when I'm not walking or reading.

    I hope you find the help that you need soon. Life is not always fair, but we all deserve a break sometime, don't you think?! ;)
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