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Failed back surgery are the percentages right.

Started by Sam227 on 05/01/2010 8:41pm

I am having a fusion and leminectomy in July. My pain management doctor said I have a 33% chance of being pain-free after surgery. Does anyone think that percentage is off a lot because people don't want to go back to work? You think people are just looking for the free services for life? Back surgery is a major surgery for all of us. It would be a lot nicer if the percentage was a lot higher that get better. Please let me know your thoughts. I am unable to do almost anything now. My choice is surgery even at 33% .

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Hi Anne D,

Hat tip to you! What you said about the edema makes perfect sense to me. I do exercise 7 days a week doing pilates, yoga and weights,but I do have to sit with my legs hanging for signififcant periods of time while driving or working. I can't do the diurectic route as my electrolytes are too easily thrown out of whack, so I'll have to try to keep my legs up more. I'll tell my doctor you get his fee not him!!! Thanks!!

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Hi Sam&Riverhawk,First, Riverhawk, Thanks for your honesty in fessing up that you've been babying and feeling sorry for yourself.Cut that nonsense out immediately. Sam to answer your questions: I had spinal fusion with instrumentation of L4,5S1 and a bone graft from my hip in April 2010. My back was a mess from arthritic stenosis, listhesis and degenerative disc disease causing severe pain. .Post op, I had moderate surgical pain but alot of muscle spasm which was relieved with anti spasm meds,ie. flexoril. I was home after 4 days and started physical therapy at home the following week being taught to climb stairs with a crutch immediately. Hospital outpatient physical therapy will end next month. I weaned myself pain meds in 2 weeks because they made me too dopey and unmotivated to move around. Like you, I was on heavy pain meds before the surgery. Then I was able to drive again. At 2 months, I had xrays of my back showing that good quality bone was growing around the fusion. a good sign. Sam and Riverhawk once you've had spinal fusion, you must become like a shark, constantly moving around for the rest of your life. Sitting for any period of time leads to swelling, pain and stiffness. Your back and your life can never be the same. If you go back to your old ways, you put the fusion at risk of failing and the surgery may have to be redone. Doing the physical therapy exercises every day is a must. Walking every day, further and further is crucial. Lose as much weight as you can to get the gut reduced. Core training must be done for the rest of your life. Every movement you make must come from the core. You can never use your back again. Spinal fusion does not "fix" back problems. Your back can't be "fixed" you can only learn to live within the limits of safe movement done by your abs, theighs and legs which must be and stay developed going forward. It's not a happy ending but it is what it is. By the way, I just celebrated my 72nd birthday and have no plans to live like I'm a cripple if I can do something about it. Get moving and keep moving!!! Gedspeed to both of you and all of my friends at Spine Universe.

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My chance for surgery to correct my problem is the same percentage as you. I chickened out to have a spinal fusion and decompression 5 yrs ago. I have severe spinal stenosis, dddisc disease and osteoarthrits and get terrible leg pain. Now the upper spine is close to that as well.

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Sam, I wish I had heard that percentage before my surgery. I had a 4 disk fusion. and they cut/or nicked a nerve. I now have limited use of my right arm - oh and the pain is worse. It's looking like I may be on disability for life. I know there are people who want to be on disability - thinking it's like a paid vacation for life. I'm not one of them. And it's nothing like a vacation. Whatever you decide I wish you the best.

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Hi guitargal,You deserve to know the facts. There's no responsible MD on this planet who would predict the outcome of spinal surgery in %. They know that there are too many variables to consider. The #1 most important factor of success is the training, expertise and track record of the surgeon. How many fusions does she or he do in 1 day, one week, 1 month? If she/he operates out of a community hospital vs a large teaching medical center with a med school that's a red flag. Doing fusions is a numbers game and like all surgeries, the more often the surgeon does fusions, the better they get at it. The fewer they do, the less expert they are at it. Ask someone who works at their hospital. The next factors concerns you. Your age, are you overweight with a big gut? Do you smoke or eat a junk food diet?How many years have you had the symptoms?The longer you wait to have the fusion, the more likely irreversible nerve damage and reduction of success. Have you had failed spinal surgery in the past? As you can see, each case has its own multiple factors making predictions about surgical success impossible.. Please don't be misled. Life after fusion is no day at the beach. Your back can not be" fixed" by having fusion. You have to take total control and discipline yourself to do core strengthening exercises every day for the rest of your life.You can never use your back again, its too fragile and you'll risk reinjury and fusion failure, your abs, theighs and legs must be developed to do the work of your eggshell back. Your days of sitting on your butt are over. We have to become like a shark, moving all the time with the gut pulled in. Using ice packs 8 or 9X a day reduces swelling and pain. Wearing a brace also helps til the core muscles develop leading to lumbar stabilization. Going back to the gym should be done only under expert guidance since that's where the muscle heads hang out competing with everyone. A daily walking program is critical for the rest of your life. After spinal fusion, the total burden falls on you. If you don't do core strengthening training and just sit on your butt, you'll be in constant pain popping OXYS and feeling sorry for yourself. You need to know what you're getting into. If you're unwilling to do the post op physical work,you're wasting your time. Good Luck!

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To all newcomers.
I started this discussion presurgery. I was really thinking the percentages were wrong. I was also new to back surgery/fusion . What we've been talking about is a fusion. You can get some true answers from people with experience here. Riverhawk ,Anne D. and myself Sam 227 were here telling our experiences. My pain management doctor is a neighbor and that's where I got the true numbers/percentages. I was also told by my pain management doctor to be where of all laser surgery centers. They say 90% plus success rate and really it's probably a 20% success rate. She did say if the insurance would pay go for it. It could be an easy fix. If you have to pay 25 to 50,000 it is wasting your money. I am five weeks postsurgery I'm walking cane free today. Still in a lot of pain I think surgical mainly now. Anne is right on exercise you really have to do them. Having the surgery/fusion done was my only chance to have my life back. I have a seven year old a 14-year-old that's why I had to try. 33% chance of being normal again sounds great. The disability Social Security I would not get enough to live on. When I started the discussion I was hoping people were just out to con the insurance companies to get free money. But I did learn on Spine universe The percentages are correct. My surgeon said I have a 60% chance or better to be pain-free. He did not promote it at all . He said it was a tough surgery. And for those who didn't have the surgery/fusion yet the first three days are Unreal PAIN after. I was in real good physical shape. I would never thought I would of had it so tough. The person that had the surgery and it failed . It's too bad you were not informed presurgery. I have go walk a 300 feet (cane free). Have a great day -- Sam

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3 doctors told me dont have surgery, 2 said do the disk-fusion. im still confused.
i have been following spin-uni for almost 7 months
for lumbar, spinal laser surgery works, but i think it depends on how much spinal stenosis and how bad are the disks.
i have cervical pain and the only surgery available is disk-fusion. after 4 epidurals ( the last was a facett injection which he put no where by my complaints) my neck is still locked up, I have a little less pain, but i think its because of the spinal stenosis i need this operation I still need to take pain pills every third day.
I still have this question in my head, does the operation make a better quality of life for the future?
or should i suffer with pain and worry that my condition may get worse? Espescially , if i get hit again!
did anyone have positive results?

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Hi Rosey, if you're contemplating cervical fusion either thru the neck or the back You'd better be seen by by a world class spinal surgeon at a world class medical center even if you have to take a plane ride to reach them. Medical centers like Hospital for Special Surgery in NY,Mt Sinai in NY, Cedar Sinai in LA, Northwestern U Med Center in Chicago,Baylor in Texas etc, you get the picture. You didn't say how much pain you're in on a scale of 1to10 but if you're just taking pain meds every 3rd day, doesn't sound like high intensity pain enough to warrent going thru a very serious, dangerous procedure carrying a certain amount of risk. What did you hope to get out of having surgery?

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Hello Sam and Anne
Annie i read your comment . Thanks!
My operation is with dr. gelardi works for HSS
Even though it sounds like a little pain. IM lying on the couch everyday.
my neck has a knot on it.
More phiscal i get, the more pain i have
im also smoking, and that relieves alot of the pain for 1.5 days
I drive a bus and cant be on drugs (tylonal with coddine, etec)
Ive had my problem a lteast 10 years, after my car accident in febuary it got alot worse.
SO my question is, Will i have a better quality of life with the surgery?
robertalso@yahoo.com

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Im pre- surgery, 6+mos since my car accident.
last night the pain woke me up
The pain is vibrating (not sharp)
i havnt decided a 100% for surgery, 95% sure
sam How are u feeling now?
I started reading this topic late,
I would like to know your outcome

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Hi Rosey, Has Dr Gilardi from HSS told you yet that the likelihood of surgical failure of the bones in your cervical spine fusing which is critically important for the success of the surgery is reduced by 500% if you're a smoker? I'm surprised that he'd even consider doing the surgery on a smoker. Anyone comtemplating spinal fusion surgery who is a smoker,or has a large belly, is grossly overweight, is a couch potatoe, refuses to walk and exercise is pretty much wasting their time having spinal fusion surgery.although many spinal surgeons fail to inform patients before they operate, The truth is that it's life changing. Fuion is not a "magic bullet" that solves your back issues. It's a mechanical procedure that relieves the initial pain but then you are responsible for your own back rehabilitation. If you slack off and go back to inactivity,you'll be in pain and could be dooming yourself to living on pain meds for the rest of your like. So give it lots of thought and for startersget off the couch. move around!! Give up smoking.
Best of luck.

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anne u dont have a e=mail adress listed
yea he told me, didnt mention %
i read that u needed to stop smoking before and atleast 6 weeks after
I just have too many symthoms
the old bones been threw too much trama
still only 95% sure im going threw with it
The pain keeps comming back, and frankly after 4 epidurals
Im fed up!
im walking everyday, dieting atleast 3 days a week
But the couch really helps stop the pain

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Hi Rosie,

I just had to jump in here and tell you Anne is 100% correct. No doctor who has a license would perform surgery on you if you are smoker. You have to be at least 4-6 weeks out smokefree.. I am an ex-smoker myself (quit 18 years ago) so certainly not preaching. But for your own wellbeing please don't even try and fake it with doctor. My BIL had to quit to have his hip surgery too. He was heavy smoker and it pained him but the hip pain was worse. So he had no choice.

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hey thanks, i guess i better quit
why do u have to stop smoking?

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Rosie
I run a support group for another surgery. They say to quit smoking 30 days before surgery and don't start till 90 days after. About 10 people in my group kept smoking until surgery. Nine out of 10 people were great only one had a real tough time. She even did well after about two months. Remember people get in car accidents every day they have emergency surgeries that smoke. Just my opinion I think the odds are in your favor. Most people won't admit it 90% of Americans are addicted to something. I am five1/2 weeks postop I had a fusion. This was a very very tough surgery for me. I hope now I'm one of the 33% that get better. Physical therapy three times a week a lot of exercise and walking. Presurgery I was in pretty good health 49 years old. I know my surgery was July 22 still pretty fresh out. I wish I was stronger than what I am. Sam

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Rosey, you asked why you have to stop smoking before having spinal fusion surgery. Smoking directly interferes with new bone growth around the site of the fusion and without new high quality bone growing around the fusion you'd be left with just the rods,screws and cages(called instrumentation) to keep your spine stable. If the instrumentation fails and it does sometimes, you'd need to undergo another spinal fusion if you developed symptoms.You must quit smoking for at least 6 months to 1 year post op,
Our backs have poor blood supply and cigarette smoking robs the blood of oxygen. Availability of a good supply of oxygenated blood is an absolute requirement for growing bone and healing . Did you say in your post that you had to smoke to control pain? What are you smoking?
Nicotine doesn't stop pain but is highly addicting. It may feel like you can't live without cigarettes but you can, the choice is yours. Please don't even consider fusion if you can't get yourself to quit cigarettes.. The post op pain and discomfort, the amount of work you have to put into physical therapy and especially the fact that you have to keep up daily exercising for the rest of your life should warn off people unwilling to do what it takes who are considering spinal fusion.Lying on the coach has to become a thing of the past. It's not especially happy news but it's the truth.

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thanks guys I apreciate the support

i realize i have to quit, not ready!
i need to try to get back to work!
my doctors say 90-95 % not 33%
maybe 33% for smokers
By the way, I like spine -universe
It seems they are for the patient
i wish more people would find this site!

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Hi spinal universe friends, can we put to rest once and for all the part of our discussion focused on what are the % of success in having spinal fusion surgery?. In a previous post, Sam227
described how he came up with the idea of 33% success based on a comment made by his pain management MD. Sam simply drew a statistical conclusion from her opinion.
No spinal surgeon in their right mind would voice such a prediction concerning %age of success. Too many variables are involved. If you do some research on line,the statistics
seems to show that smokers, the elderly, those who have chronic symptoms of pain, nerve damage etc for long periods of years, a history of failed previous surgeries have a much lesser chance of fusion being successful. This isn't an opinion, it's scientific fact. The skill and track record of the spinal surgeon is really critically important. If a previous fusion failed, for God's sake don't let that same surgeon or one of their partners or buddies operate on you again. Find a new one at a major teaching hospital with a sterling reputation even if it means having to travel a good distance. Ask for a list of patients that you can speak with. It bears repeating: You have to take charge of this situation and do the arduous work of recovery by yourself. That means giving up smoking, losing weight, continuing doing the exercises every day on your own, using good body mechanics for the rest of your life. it's a lot of effort and if you're unmotivated or ignore your doctors instructions then you're looking at a life of chronic pain and limitation. Again it's not happy news but it is the truth. let's stay focused on what it takes to return to a normal relatively active life.

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Anne - you're tough but I think you may help to save my sanity. The Dr only gave one post op suggestion - walk. I try to do that, but I lose my balance a lot. I bought a walker at a yard sale - so I think that takes away that excuse, except the humidity is 90% here today - and I tend to pass out from heat. Where can I find the core excercises and the ones recommended for cervial fusion and degenerative disk disease and scoliosis? No one has told me about these, the only PT I got was at home immediately following the surgery, and everything has gotten worse since.

They cut or nicked a nerve during the operation so I am paralized in my right arm at the elbow (of course I'm right handed). I need to find out about a doctor who can order tests of the nerves - but I don't know what kind of Doc that would be. Neither my surgion or the referring Neurosurgion will take an appointment with me. The referring just sends a PA, the surgion just changes my appointment to be with the Pain Management Dr and then is not in the office when I am there.

It's hard to take control of my own care, when I don't know what to do. I used to be very active - but because I'm "old" (I'm 52!) they figure I should just sit back and take it. I have a primary care dr that I had to stop using when I was preparing for the surgery - the surgion didn't like him. Now all my Dr's are an hour away or more. The local Dr. I dropped saw me a month ago - he wants me off all meds he did not supply and refused to fill and anti-depressant/pain pill Cimbalta, which really works for me. I am frustrated and tired, and I'm afraid that today I'm just filled with self pity - I have to admit too - I'm just plain afraid.

Thanks to everyone for letting me know that I am not alone - not by a long shot!

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HI guys,
I'm almost 6 weeks post op. I think I am in more pain today than I was two weeks ago. I'm walking with a cane again. I know there'll be ups and downs . I hear people say they feel better right out of surgery. Any thoughts? Anne D it is right I am not a medical professional. I don't believe she isn`t either. These are all our opinions and our experiences. And What We Found out through our sources. Always remember everyone this is just our opinions and thoughts. I don't think anyone responding is a doctor. If we wanted opinions ALL from our doctors we would be talking only to them. We would all think we had a 60% to 90% chance of no pain after surgery. Thanks Sam

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Sam, a couple of things that may work to reduce the pain you're experiencing. Ice your back with a
reuseable rectangular gel icepack that you keep in the freezer 9 to 10X a day. Ask your surgeon for a back brace to support your lumbar region until you build up your abs. Don't sit for more than 30 minutes at a time. When you're lying down, prop your legs on 2 or 3 pillows. Your pain could be from spasms which are very common after fusion surgery. Get an RX for flexoril or baclofin. They reduce the spasms which can be causing some of the pain. Pain could be a signal that you're not keeping the gut pulled in and you're abs engaged. Hope this helps! My best, Anne

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Hi Disability-is, Did the surgeon nick a spinal nerve or a peripheral one. If peripheral, it will eventially grow back in months and the paralysis will subside.. Sounds like you might want to visit a medical malpractice attorney to review your case. The yellow pages are loaded with them and they don't charge unless they win you a settlement.
If you already have a med mal attorney, they can hook you up with all the doctors you'll need to have testing etc and also get you new ones since it sounds like your doctors are acting like you're poison(they're probably afraid of being named in a lawsuit) As far as exercising what did the physical therapist show you? Do that every day and take a daily walk on that walker you found at the yard sale.Your loss of balance could have been a side effect of the Cymbalta. I'ts probably a blessing that your doctor discontinued it. Best, Anne

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Sam,
I've been following you progress & I'm so sorry to hear about your treatment by your surgeon following your surgery. You would think thses guys are aware of the pain that such procedures can cause.
I think Anne is right about the smoking. I had a bone graft for a dental bridge several years back. My dentists warned me to quit smoking. At the time, I thought it was because the graft was in my mouth, but after it didn't take, I learned that it was because of lack of oxygen in the blood.
I'm still smoking, but willing to stop if I can get rid of at least 50% of this pain. I don' have surgery scheduled yet, waiting for an appointment with a neurosurgeon. I'm hoping that it won't take months for them to schedule the surgery as I'm finding it harder & harder to maintain even a part time work schedule. I'd hate to have to forfeit my job if surgery can make it possible for me to keep it.
Please keep us posted as to your progress. Prayers in the wind to you.

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Hi guys
riverhawk how did you surgery go? I hope everything is well. Annie D. where do you live? I was at the physical therapy yesterday . The therapist was talking to a Anne. A very strong 70-year-old. Just curious if it was you. I'm 6 1/2 weeks postsurgery and going to my pain management doctor today first time today postsurgery. I'm curious what pain meds are they going to keep me on. I'm still in a lot of pain especially doing the physical therapy and my exercises.. Sam

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Hi Sam, I live in a NYC suburb and take physical therapy at a outpatient hospital based rehab dept. By now your physical therapist needed to have taught you body mechanics exercises to keep your different ab muscles tighened before attempting any quad, hamstring calf or hip strengthening exercises or engaging in physical activity such as bending, lifting light objects, getting in and out of bed, or a chair or getting in and out of the car. Engaging the abs is basic since trying to use back muscles for performing daily activities causes pain. Have you had xrays yet to see that new bone is growing around the hardware at the fusion site and the hardware hasn't moved? If you had a bone graft from your hip, pain could be coming from that site but feels like its coming from your back.That can go on for months as the graft site in the hip heals.. Icing the back often reduces the pain. I'm almost 5 months after surgery and can see that this is a long term deal that can't be rushed. The pain is slowly subsiding as time goes on. Please tell us exactly what the pain management doc plans on doing for you? Best of luck.
PS. I only sound tough because I don't want to be disabled for the rest of my life by this back surgery and be forced to live a smaller and smaller life that revolves around taking pain meds. For me, compliance, staying active, following exactly what I'm told to do by the doc and physical therapist and not being lazy or self pitying leads to success.. It is hard work and requires me to be tough on myself . When I go off course and do it my way,all I feel is a lot of pain, so there really isn't a choice. It's either tough self compliance or more pain. . Spinal fusion ain't for sissies, we've simply exchanged one kind of pain for another!!.

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Hi Juvi v, The medical profession is loaded with misfits who are unable to treat people
humanely. We expect them to show kindness and compassion...many are incapable of feeling anything, living in their heads, not from their hearts.
Consult them for their skills and ability as you would a car mechanic. Truth be told, we don't need
bedside manner, we need their knowledge about what's hurting us and how it correct it.. Don't take their cold, arrogant detatched behavior personally,they can't help it, They we're born that way. the condition is called Asberger Syndrome and many who choose the medical profession are afflicted with it..

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Hi Anne D and disability,
I must respectfully disagree with you Anne re: cymbalta. I don't know all the reasons disability is taking it, but one of areas the drug is marketed for is balance issues and various muscle, nerve problems. Also, she should not just be suddenly discontinued from the drug. If going off she should deacrease slowly as the side effects could be worse than the surgery! Any doctor that tells you not to see a dcotor you like and have a relationship with has a few screws lose. I'd get rid of HIM.

Disability- I don't know if this is same as your case but the anesthesiologist hit a ligament at same place you have problem with elbow. But mine was VERY painful and it took a long time to heal, but I got lidoderm patches from my neuro and used them faithfully daily. I think it was about 4 months to heal. Also, it is not unusual for neurosurgeon to refer you to pain doctor once he reviews your post op xrays ( or in my case, CT scans and MRIs). They did their job which is to cut and as in my case just didn't know what else to do. I went to a differnent Pain doctor than the one he referred me to, and I'm happy with her. If I were you , I'd call your primary doctor and get back on cymbalta asap. Wtihdrawls from that will definitely make your pain and other issues worse. I don't take it myself even tho offered to me, but I do know it helps a lot of people for the reasons previously stated as well as an AD.. I stay on its cousin effexor xr. If a doctor took me off that cold turkey (even tho I am under the recommended dose) I would never see him/her again. I took myself off once after only taking a few days. I felt like I was blowing through life sideways. It was awful for a month or so.
I don't know exercise for cervical fusion but pilates is excellent for strengthening your core muscles which support your back. I had been doing mat work for years before surgery and my neurourgeon told me 99% of his patients cannot do what I can because I am so flexible. That was no comfort to me and my pain however or the edema.

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Anne D. I didn't mean anything bad by saying you were tough. I respect your advice, you are three months ahead of me. You know what I'm living through right now. With fusions we did change pains but this one we asked for to have a better life. For the last year and a half I have had no quality of life. I had to do the surgery for my two children to give them a real-life. Self-pity self-pity yes I think we all want to roll up the in and that ball. At least I know I do. Do you think we did the right move with our back surgeries?
I went to my pain management doctor today remember I'm friends with her she's a neighbor. She wish I brought my operative report with me she did not receive one. The surgeons give pain management doctor's attitudes to not just us. The surgeon never sent her any kind of report even to say I surgery. I asked her where should I be should be pain Wise ? She said a lot of patients don't usually make ther two-month visit after surgery. She also said on pain sometimes they operate on the wrong thing.Not what`s causing the pain. Sometimes pain doesn't show up on a MRI ,x-ray or in any test where the pain is truly coming from. I hope you have a lot to say on this!!!! I guess I'm looking for help now again. Thanks Sam

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Hi Sam,Okay, I have to fess up. I'm an RN with a lot of 1st hand experience with doctors. There are several points to challenge with your pain management doc. She's got an obvious gripe(that's a nice way to put it.) against surgeons, not just yours and she's been less than honest with you.
She failed to tell you that HEPA Federal laws forbid your surgeon from sending her ANY of your reports.
She already knows that and is playing with you.. The patient has to ask for a copy of the operative report from the surgeon. He is required by law to give it to you and you need to makes copies and give her one. The same thing goes for all of your xrays reports, MRI reports and so on. You as a patient own those reports. I think she's being sadistic (they tend to be that way)inferring that he may have operated in the wrong place. In a previous post I told you that typically pain management docs hate surgeons and knock them every time they get the opportunity and the reverse is true but surgeons think everyone is an idiot and hate everyone.
Surgeons don't have much of an interest in their patients after the surgery is done and want to palm them off on other docs. That's they're personality type.. The field of medicine is loaded with a lot of brainy misfits who lack human compassion . Many have the personality of a shoe and many suffer from Asperger Syndrome which make them smart but with no connection to their hearts. We have to stop expecting them to sooth us and make us feel better. They're no different than a car mechanic with a little more knowledge. There's nothing magical about them.
Sam, I told you before, get a new pain management doc, she's mean spirited.
My very best to you my fellow traveler on this road to recovery. It will get better but it takes more time than we thought it should. Stay positive and keep posting on SU.

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hey anne
u seem knowlegeable
the last pain management doctor i went to for the 2 facet epidurals at the same time didnt come to see me before or after the procedure. Should i hold this against him? i was told that i was thrashing around during the procedure and pulled off the iv, I was sleeping at the time.
Should i be worried?
your last reply u said that pain management doctors hate surgeons, of course they make their money controling pain.

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