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Taking control of your own case management

Several weeks ago I underwent a Facet Joint Injection. 24 hours later in the middle of the night I woke up in a sweat, short of air and chest pains. This isn't new to me as I have a stent and diagnosed Coronary Artery Disease.

So, I called my PM office and left a message on their "Clinical Line". The nurse called me back a couple days later. Keep in mind this particular nurse makes Gordon Ramsey from Hell's Kitchen look like the Pope. Anyway, I explained what happened and asked if the doctor would want me to go through the 2nd round of shots that were scheduled for today.

She asked me to describe the symptoms. I explained it all (which is textbook Atrial Fibrillation) to her. She asked me, "do you have stress in your life"? I said, "um yes, who doesn't." She then said, "you were just stressed out. There is no problem and just need to relax and there is no problem with coming back in for the next injection". I sat there in complete shock for a minute before I spoke next. I asked her if she reviewed my file before calling me. She said yes. I then asked about the similarities of the symptoms I had with that of A-Fib. She didn't say anything. I then said, "I have CAD along with a stent in my heart". She then changed her tune to say that I was in serious danger and needed to see my cardiologist immediately. Funny how she was looking at my chart and went from "no problem" to being in "serious danger".

I had already called my cardiologist to ask him if I needed to be seen before having another injection or to proceed with it. He called me back later and verified that it was textbook A-Fib. I asked why it waited until the middle of the night to flare up. He explained that when your heart is at rest, it is more likely for fluid to build up and cause the muscle to act up. He went on to say that it was safe to have another injection but to let him know if I have another episode after the injection.

I bring this up to encourage everyone to not just accept an answer that doesn't sound just right. Medical records are great, but humans interpret them (or not). So, ask questions, be informed and remember that ultimately, you are responsible for your own health.
Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2


  • Keith, that sounds terrifying but I'm happy you seem to be ok. You are very right about taking your own care as a priority and being a self advocate. There are great physicians out there and then some that aren't so great. Let us know how your next shot goes?
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • SavageSavage United StatesPosts: 5,476
    edited 05/21/2015 - 7:08 PM
    Thanks for sharing your experience!
    It is so encouraging to hear how you handled such a frustrating, to say the least, situation.
    You seemed to be without anger, sarcasm.......and handled yourself with patience and ...professionally.
    I'm thinking of you as professional, representing a patient...just so happens to be yourself.

    I have had a doctor or two who were not my specialists, but read my history, and took my conditions and my list of medications very seriously, re their care of me. But they saw me only one or two times.

    Sometimes specialists, or their nurses :) .....may tend to think and react to symptoms as they relate to their treatment for us.
    I know all doctors have complete awareness of all conditions when we sign up for initial office visit, but if we have a few specialists to keep us stable...it can add up to a lot of info.

    If I have any changes...with anything medically, I let each doctor know, so that way I try to keep them all in the loop and they have general knowledge of what other docs are doing to keep me going. :)
    Sometimes just managing my care is a full time job.....for me!
    I keep a list of my conditions with me at all times. I am no longer a good historian. I'm forgetful ....and it just gets to be so detailed sometimes.

    When or if......no, it's when.......I next feel frustrated with medical situation, your example would be a fine one to emulate!

    I see you around the site regularly....and always get something for myself from your posts!
    Thanks again for sharing....and I certainly hope you feel better and your heart does well.

    Spine-Health Moderator
    Please read my medical history at: Medical History

  • dilaurodilauro ConnecticutPosts: 9,877
    edited 05/22/2015 - 4:24 AM
    your point is so very valid.

    And I am glad that you took matters into your own hands. You wouldn't want any procedure done that you know might be life threatening to you.

    To coin a phrase from Judge Judy If it doesn't make sense it isn't True

    Then act on that......

    Keith, good advice for everyone . Thanks
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • itsautonomicitsautonomic LouisianaPosts: 1,819
    I've said if my entire chronic pain life, you know you body inside better than any dr in the world . They may know it anatomically better, they know why tithings are happening but you know your body longer than anyone and can sense when something isn't right. If you don't know your medical condition in and out and advocate for yourself you are literally risking your life in my opinion
    Do your due dilegence, trust you know your body and question everything if it does not fit. Advocate for yourself and you will be suprised what will be revealed trusting your body and instinct.
  • It appears I'm a creature of habit. I had the 2nd injection Thursday and last night it happened again. This time wasn't so bad and I was expecting it. I'm fortunate to have a 12 lead cardiac monitor at my disposal due to where I work (thank you, EMS employer!). I hooked myself up and it showed ectopic changes, pre ventricular contractions (PVC's) and "T" wave abnormalities. I'm used to the "T" wave issue. I've had that most my adult life along with a slight left bundle branch block. Strangely, my pulse rate was in the low 50's after being up and moving around. Typically, my pulse rate is higher.

    I saved the read out strips to share with my cardiologist. I'm hoping he will continue allowing me to get the shots. There are few things that help with my pain level more than the Facet injections. We tried RFA several years ago and it just didn't seem to work good for me. Hopefully, tonight will be a quiet night and I won't have another episode of this happening. Luckily, my wife is out of town this weekend so she doesn't have to put up with the interruptions of everything that was going on.
    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
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