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hospital refused to do discogram



  • You know your ortho best...so just go with your instincts. I was just thinking that if the doctors have talked and he has processed the information and does not bring it up to you, you could just move ahead and cover new ground. I imagine you are giving this situation a lot more thought than he is!
  • I'm so thankful I have all of you to get me through this. I'm feeling much better about this now. I was really concerned about what the doctor might think, but I'm just going to have to explain to him that I'm not ready to give up. I can understand not wanting to do surgery, but testing for what's wrong shouldn't be such a big thing. One of my friends around here also suggested someone going with me to my next appointment. I think that having someone go with me could either help me or hurt me. It depends on what they say. My mom, for example, could make things worse I think. She would say too much and come across like she has to take care of me and I'm helpless. That's not true. Others could help me with their words, but I wonder what the doc would think if I had to have someone sit and "hold my hand." I'm not sure what I'm going to do. I just know I'm tired of the appointments, the money spent and the fact that I have to prove I'm stable (in the head, that is) in order to get adequate testing. I know a discogram is risky, but I've been through one before (20 years ago) and I'm not 20 anymore. The doctor at the hospital insulted me by saying, "This is the most normal MRI I've ever seen for a 42 year old woman." I almost said, "Well, this isn't the most normal pain in the leg and back for a 42 year old woman. And that's why I'm here." But I held my tongue.

    Anyway, just rambling. I do appreciate everyone's interest in my circumstances. It really helps to have people understand and voice their opinions and ideas.

    Thank you!!!

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  • If you don't mind, could you tell me what your symptoms are currently? When do you have the pain? What relieves it, if anything?

    Has it been getting continually worse since Sept. or did it suddenly get worse in Sept. and you've been dealing with it since (at about the same intensity?)

    My second surgeon will conduct the exam, look at the MRI with you, and then give you a diagnosis and explain that you need surgery. He then asks that you return in a couple days with your husband, or another person, at which time he goes into detail about the surgery, answers questions, etc. He said he knows from experience that the patient is usually in shock after hearing the word "surgery" and his/her brain kind of shuts down. S/he does not take in any more information after that point. So he has the patient return with another person so the two can take in the details together.
  • Actually, today and March 27th have been the worst days, as far as pain go. It starts at my right back, down butt, outter back of leg, down calf and through outter foot to pinky toe. It's at about a level 4 pain right now, and has been since about 2 or 3 pm. (It's 7 p.m. now). The 27th I had to sit all day in the hospital while my son had surgery, so sitting was just horrible. That's when the pain is worst. Also, when squatting down. The only time the pain is gone is when I lay down on my stomach. When the pain isn't so bad, it's at about a 2 pain level and the pain is mostly in my outter foot and pinky toe as well as my outter calf.

    September, 08 is when my pain came back after having surgery in May, 08. The pain has been bad, better, bad, worse, bad, better.... you get the idea. Lately, though, it's been worse. I'd say for about the last 2 months, it's been getting worse. The thing is, why is the doc still going by an MRI done in Sept/Oct, 08? It's April for Pete's sake and the pain has increased. I just don't get it. (Sorry, rather angry right now. So so so frusterated by this whole thing!)

  • I think the MRI may have to do with insurance. I think one every six months is about all they will routinely pay for without jumping through many hoops.

    Do you think you herniated a disc? Or, what do you suspect?
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  • Yes, possibly - herniation. I did something horrible today - I know that (how ironic). I haven't had this kind of pain since I don't know when. My entire leg hurts (On the outside) rather than just my calf and toe. This is horrible. It's almost been 6 months now for the MRI. I had it in October 08. When I see him May 4th for a regular ortho visit, maybe he'll consider if I tell him that I've been having some really bad days of leg pain.

    Do you know how accurate an EMG is? If my leg pain comes and goes, will it still be able to tell whether or not the nerve is being irritated? There's a very very small indentation into my S1 nerve root on the MRI and myelogram, so something must be rubbing on the nerve - I hope it's enough to slow down the EMG and give proof of this. I have an EMG done Tuesday, and I'm hoping for some answers. The EMG is done right in the ortho's office, which is nice, but he isn't the one who's doing it. Maybe I'll ask if they can tell anything Tuesday.

    Before my very first surgery (22 years ago), I had an EMG and was surprised to see that something did show up. I say "surprised" because the CT scan hardly showed anything (just a bulging disc).

    At the next appointment, I will probably be letting the doctor know how very frustrated I am with this whole process, especially after being sent home Tuesday. I will let him know that I'm not upset with him, but with the fact that I'm not supposed to want to get to the bottom of this. I'm supposed to just sit and wait and live with the pain. The part that gets me the most is that all the tests have not been run that can be. The discogram is supposed to be very specific - this is exactly what is needed. I've read up on why doctors do the discogram on several websites, and the fact tat my MRI and myelogram aren't showing much are some of the main reasons why.

    Anyway, I'll stop now.

  • Yesterday I decided to call my family doctor to see what the hospital doctor had to say to her about the discogram. Rather than getting a call back from my doctor, the nurse relayed this message... "Dr. W. said that she's no longer able to order tests for you. You will have to go to your neurosurgeon or ortho. for that." I guess this tells me that she wants nothing else to do with me. Isn't that great?!

    That's the latest.

  • All I've ever read or heard indicates that an EMG is only as reliable as the person who is giving it. There can be plenty of room for misinterpretation. As I understand it, yes the test will reveal the health of the nerve, how well it is receiving the signal from the brain.

    The fact that your leg pain comes and goes has more to do with what is pressing on the nerve.

    My PM doc, my ortho and my physical therapist were all telling me my symptoms were indicative of L3 nerve compression and said my MRI also showed a lot of stenosis at that point. I also thought I had peripheral neuropathy. When I had the emg and nerve conduction study, I could tell the doctor kept repeating certain parts of the test and his body language indicated to me that things were not adding up.

    After the test I asked him what he found and all he would say was that he needed to go back and review my MRI films and study the results a bit more. Turns out I do not have peripheral neuropathy at all...and I had chronic radiculopathy at L5--worse in my left leg than my right. (All the pain I feel is on the right.)

    So, at best, all these diagnostic tools are at best, a guide to what may be causing the pain.

    Just out of curiosity, is your family doc female and is the discogram guy male?
  • Yes, my family doctor is a female and the doctor who was "supposed" to run the discogram at the hospital is a guy. Why do you ask? The doctor at the hospital also said that he knew my orthopedic doctor (also a guy) and that he is a very good surgeon. He almost acted like I was going behind his back by asking my family doc. to order the discogram. In fact, he insisted that I stop trying to run my own treatment plan. He said, and so did his nurse, that I need to stick to one doctor. I, however, do not believe that. I feel that I need a number of opinions. Doctors are also human and have their own ideas and thoughts.

    At my next appointment, I will be letting my ortho know that it was my impression that patients are encouraged to get 2nd, 3rd, etc. opinions. I will also be letting him know that I was doing just that, and that I was following the advice of a surgeon I had spoke with in another state. I've got everything written down as to what I'm going to say. And I'm going to actually "memorize the script" this time. There will be no mistakes in what I say, and I will make sure the doctor understands that I am the one in pain; I am the only one who has to struggle each and every day and I am the one who has to pay for these tests that are being done. I will also let him know that I am having to find and pay someone to come into my home and watch the daycare children each time I go to yet another appointment. I will either bring my husband or a friend with me to support me this time, and I will explain what happened at the hospital. He will also hear that I have been 100% honest with doctors and that I'm just trying to get to the bottom of MY pain, not the doctor's pain, but MINE.

    (Can you tell I'm just a little upset with this whole issue?) :)

    It's funny how it's been 7 months I've had this pain, and the doctors want me to be patient. HMMMMM. I thought I was.

    Thank you so much for supporting me in this.

  • I have heard that doctors can get irritated quick when they feel like they are being second guessed. I have run into some who don't like patients being proactive about their care. I think that the ortho may not like the fact that you are listening to another doctor who has never examined you. I'm just speculating as to why this is going on.

    Anyway, you have a good game plan and hopefully things will work out and they'll order the discogram. I would think it is appropriate to have it if the other tests were inconclusive- that's my 2 cents. Just stick to your plan and memorize what you're going to say and you'll be fine. Take care
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