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hospital refused to do discogram

AnonymousUserAAnonymousUser Posts: 49,322
I've had an MRI, myelogram, physical therapy and nerve block so far, and my orthopedic doctor is still at a loss. He can't seem to find anything wrong, although the nerve block did kill the pain I was having at my S1 nerve root. (I have right leg pain all the way down to my pinky toe after 2 lumbar laminectomies.)

I decided to go ahead and ask my family doctor if I could have a discogram, at the request of a doctor I've been talking to out of state. I've talked with this doctor on the phone and heard great things about him. My family doctor decided to go ahead and order the discogram.

When I got to the hospital, I waited 2 1/2 hours for the doctor to come out and tell me he's uncomfortable doing a discogram on me. He said my MRI looks normal and the discogram wasn't ordered by a surgeon. He told me that this is a risky procedure and I should just stick with one doctor to run my medical care. I felt like a fool.

So I left, shocked and not knowing what to do next. I will return to the ortho. surgeon here in town who's now ordering an EMG, but is still at a loss. The doc. from the hospital is going to call my family doc. and tell her what he did. I believe he said he is also going to call my ortho. surgeon, even though he didn't order the test. (Does he have the right to do that?)

I'm concerned of course, that I will look like a "crazy person" who just wants to go from test to test in order to "get attention." I sure don't want doctor's to get this impression, being that the pain in my leg has stopped me from living my life. I just don't want to give up yet as far as trying to find out what's going on.

I see the ortho.doc. May 4th, and am asking for any suggestions on what to say when he starts quizzing me about the discogram. Can anyone give me some advice on how to explain that I just want to find an answer? I believe that this doctor will no longer want to treat me. Does anyone else have any thoughts on this?

csp
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13

Comments

  • sunny1966ssunny1966 VIRGINIAPosts: 1,385
    I hope you can find out what is causing you continued pain. I started to give you advice on dealing with your doctor but I can't do it because I can't deal with my own.lol I hope you feel better soon. Good luck with the ortho.

    Debbie
  • I can certainly sympathize with you. I have had a fusion and a lami-foramenotomy in the past year and still have the same sciatic pain. I too am more interested in chasing down the cause of the pain than receiving prescriptions for pain meds. It is very frustrating.

    Is your ortho the only game in town? Was it a PM doc who refused to do the procedure?

    What is your main reason for your appointment with the ortho in May? If I were in your shoes, if the topic even comes up, I would explain to the ortho that you consulted with a surgeon in another state, in an attempt to get to the bottom of your pain issues. Explain that your pain is keeping you from being able to live your life and you are searching for answers. I would just tell him what happened...and see what he says. It's not like you have a long-term contract with the ortho. You are entitled to shop around, just like you would for any other product.

    I had my second surgery with a different surgeon from the one who did my fusion. And, he had just joined the clinic where the first one is located. When I inquired if this might be a problem, he told me just what I told you in the preceeding paragraph. Doctors realize that there might be more than one way to approach a problem and that you are entitled to search for an answer.
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  • Thank you so much for the encouraging words. No, this ortho's not the only one in town. However, he has spent so much time with me and really discussed things in detail with me. (Others have not done that.) I don't see how I'll be able to go to another ortho or neuro if my primary doc. thinks I'm nuts for asking her to order the discogram. She's the one who would need to send me to one.

    The doctor who refused to do the discogram was the actual doctor who was going to perform it in the hospital. I don't know exactly what kind of doctor he was, but he came out with his nurse and began explaining to me why he didn't feel comfortable.

    The reason I'm going back to the ortho is because he's going to bring up my case with some other physicians at a physicians conference. He wants to get their ideas on what they would do or think. But now, who knows what he'll say to them. "She's trying to treat herself..." Who knows. And they'll laugh and say, "I wouldn't touch her." He also is having me come in for an EMG this coming Tuesday. If that shows something, maybe he'll believe that I have pain coming from that area (L5-S1). I'm totally confused, because he had me do a nerve block to see if it would relieve my pain, and it did. But then... he still doesn't know what's wrong. What a waste of time and money - having a nerve block done for diagnostic purposes, and then....nothing.

    Basically, my main concern is... I've ruined any chance with this orthopedic doctor continuing to search into things for me. I think your advice on just telling it the way it is, is the right thing to do. I will tell him that I'm just trying to get to the bottom of this, because this pain has limited me so much. Maybe if I tell him that when he said he wasn't sure what's going on, I felt that getting the discogram was at least another attempt at a diagnosis. I wasn't trying to go behind anyone's back, just listening to yet another doctor's idea.

    Thank you again.

    csp
  • If the ortho is really annoyed, you could just apologize and tell him the pain is making you crazy! Just kidding. You could apologize and just continue explaining that you are desparate to find answers...and ask him about the block you had and was it diagnostic and what did it show?

    When I have had those diagnostic blocks, I never felt one bit different. The surgeon that performed my second surgery looked at the MRIs and read the nerve conduction study and the EMG and pretty much based his decision to do the foramenotomy on the EMG. Short of getting in there and doing exploratory surgery, (which they are loathe to do because of the scar tissue issue and just the danger of making the patient worse than prior to the surgery) the docs have to depend on what they can learn from the imaging and whatever diagnostic tests they order. It is not a concise science.

    It sounds like your ortho is interested in helping you and is trying to find the answers. I would just wait to see if he brings it up. Do these doctors all work out of the same hospital? Anyway, just be honest and explain that the phone doctor suggested a discogram and you thought it might help get to the bottom of your pain issues. And you didn't think about the consequences of your action -- that your ortho might think you were trying to go behind his back....It sounds like you need to keep this guy on your side and that he is trying to help you.

    Is the EMG done at your ortho's office? Who does it?
  • I've been in this situation as well and I can get fired up over it too! (climbing up on a soap box) If we are paying and it's our bodies and we aren't getting anywhere, what's wrong with getting your GP to send you for the discogram. I don't see how the hospital guy refused the orders. I mean, who's he to do that? If anything was seen, the results would go back to your GP, then the ortho or Neuro could get a copy from your GP. It shouldn't have mattered as long as it was a medical doctor that ordered the test.

    Do not apologize! Do not feel bad that you tried to get further in your search for relief! You didn't do anything wrong at all or illegal or unethical! Keeping loyality is for the birds when you are hurting! It's not an issue of going behind their back, it's about being your own advocate and trying to get some action. I get so tired of trying to be patient while they charge you to go through weeks and weeks of their own guesswork on you, checkups, and doing nothing. I realize that it's a science and everybodies different but come on...there should be a limit to what we have to endure to if it's possible.

    My NS ordered the myleogram and discogram to be done back to back to get it over with. It wasn't fun at all, but we had an answer after it was done, luckily.

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  • I think there's a possibility that the hospital doctor wasn't comfortable getting that discogram request from a primary care physician. Usually OS, NS, or pain mgt will order that test for you. When we first injure our backs, the first stop is the PcP and if it is a complicated back pain, he'll order an MRI.

    I hope that your ortho doctor will understand that you're merely trying to figure out what is wrong. You were just following advice from another doctor and there shouldn't be any conflict. Who wants to go around having pain and not know the reason? That would drive me nuts.

    What did they say about your scar tissue? I have it too and it was seen on an MRI and my doctors are taking measures to treat it. When that scar tissue pain became acute, it was one of the worst pains I experienced. It felt like my back got hit by lightening and the pain shot down my leg. I fell over but didn't hit the floor thanks to my husband's quick reflexes.

    Maybe your OS will come around and order the discogram so that you can find out for sure what is going on. Just ask him if it is appropriate since the other tests were inconclusive. Someone has to do something to help you.
  • What are your doctors doing about your scar tissue?

    Also what kind of effect are you having with cymbalta? How long have you been taking it?
  • Thank you so much for your help everyone. I agree that it shouldn't matter what kind of doc. orders the discogram. However, I obviously don't have a say about my own body. I don't dare upset my ortho surgeon, since he's spent so much time listening to me - more than any other doctor this far. Maybe he just wants my money. I'm starting to wonder. But the fact that he still wants an emg done says that he's still looking into things. Maybe he'll just see that I'm desperate and eager to get on with life.

    Gwennie, you said you'd wait until the ortho brings it up first. Just curious... don't you think I should bring it up to get it out of the way? If he's already formed an opinion about me and doesn't want to discuss it with me, I won't have a chance to explain myself if he doesn't bring it up. (Sorry - long sentences.)

    The doctor at the hospital does know my orthopedic surgeon. And I believe he said he was going to call him. Does he have the right to do that if the order wasn't from him? The order for the discogram was from my family doc., not the surgeon. It seems like the doc. at the hospital wants to cause me problems for who knows what reason. Even the hospital doc's nurse started telling me to only have one doctor take care of me. She insisted that my ortho is a good doctor over and over. I told her I knew that, and that I am just trying to get answers.

    I don't feel I should have to apologize to any doctor; however, this is the 2nd doctor here in town I've seen for this, and they all seem to know each other. They talk about each other by their first names, so everywhere I go, I feel like the doc. before is making decisions for the current doctor. And I don't have money to waste on things like that. So I almost feel like I have to kiss their a.... in order to get care. (sorry, I don't know how else to put it.)

    Again, thank you. And I AM DEFINITELY using these suggestions at my next appointment with my ortho.

    csp
  • I'm sure your in alot of Pain and you Probobly have something Seriously wrong with you. Sometimes nothing shows up on a MRI. I'm guessing the Dr. Refused to do the Procedure because of certain Guidelines he hasto go by and he Probably wasn't aware of the Real Pain your In. Don't feel like a Fool! They messed up they should have Researched your Condition before coming. I assume he's probably afraid of the Risk involved with this Procedure and he being Responsible as a Dr. if something went wrong. It is annoying sometimes when Drs. don't understand the Pain were in and Treat us as if we don't know anything. I think the Dr. who ordered your Test meant well but probably should have known if they would accept you or not for the Procedure. Man I wish you didn't hafto go through all of this. it happens to alot of People I'm sure. Write a Letter to Voice your Concerns to that Drs. Office. Explain that you wish the Dr. did his Homework & they Called you before coming. Just think though it's probably better that you didn't get the Procedure bcs things happen sometimes for a Reason. Imagine if you did get the procedure and it only made your Pain worse.
    Have you had an EMG test done to Test your Nerves and Muscles? This is another Test they can do to Rule out other Symptoms that won't always show up on an MRI. I would ask the Dr. if he Recommends other Test like an EMG. Don't give up on Searching for Answers. Be your own Advocate! Research, Read and continue Asking your Dr. for help. If you don't feel your getting the Help you need request another Dr.
    I hope it all works out.
  • Hi Gwennie, well.. when they found it, I was immediately scheduled for an ESI. The doctor did discuss options like lysis of adhesions and SCS and stim implantation. The ESI caused me more pain and grief, and I'm weary of having the lysis done because they go in caudally and I heard it's more painful. My meds were adjusted and they are willing to try other meds if necessary. I've been on Cymbalta for 7 months and I've tolerated it very well. Don't take it in the evening or else you'll have terrible insomnia; take it first thing in the morning. They will start you at 30 mg and titrate you up to 60 in 2 weeks.

    CSP, can someone go with you to your ortho appt for support? That way there is less chance of things going south. I do hope your doctor is open to suggestion and doesn't resent the PCP for referring you for a discogram. Did you get a chance to ask the doctor at the hospital why he wants to talk to your ortho? You certainly have done nothing wrong and I'm sorry you have to worry about what's being said privately between these doctors. Hang in there and have faith that things will go in your favor.
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