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Old 03-05-2013, 10:46 AM   #1
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Question Getting a second opinion, what should I ask?

I am veteran to having back surgery. I have had 5. I have had two open discectomies, 2 PLIFs, and a staph infection washout. However, I am not good at asking questions. I get in the office and forget everything I want to ask. My current NS is very friendly, I get lost in our good relationship, he reminds me of my dad. I am the type who trusts doctors immediately. Therefore, I really don't ask any questions. I am very fortunate that I did find a real good NS right out of the box.

I have a bulged disc L5-S1, at my last appointment my NS told me that he wanted me to blow out my disc before he would do anything. That was back in early January. About mid February I began experiencing sciatica in my right leg with some pain my left leg as well. So, I did what any normal spiney would do. I called my NS and told them about the pain and his nurse proceeded to inform me that there was nothing they could do for me. I think I may blown the disc. I have been diagnosed with adjacent disc disease. They offered me an injection and I refused because they don't seem to work for me. I have had several tries at injections. My husband talk me into getting a second opinion. I called my PCP and he hooked me up.

So here I am today, getting ready to see my new NS next week. I want to be an informed patient. I want to be able to ask the right questions. Can anyone give some advice on what kind of questions I should ask? I am very nervous about this appointment. I am afraid that he won't believe that I am suffering. Thanks

Jennifer

 
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Old 03-05-2013, 12:59 PM   #2
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Re: Getting a second opinion, what should I ask?

I do remember your story! First of all, if you like the first new neurosurgeon, I would suggest you go back to him and tell him about the changes you have experienced since you were last there. Unless you think his nurse was directly quoting the doctor, I wouldn't let her deter you.

I had a slightly similar situation. My surgeon didn't think there was anything he could do for me after I'd had one fusion with another surgeon and he had done a smaller procedure that he felt would decompress the nerve that seemed to be causing my sciatic pain post fusion. When it failed, he didn't see anything else that could be done...but I felt sure there was something mechanically wrong that could be addressed...I just needed to convince him of this...so I just kept making appointments with him...and eventually everything worked out.

He never asked me "why did you come back when I told you nothing could be done?" He realized I was determined and wasn't going to give up, so he didn't either. It took us almost 8 months to determine what "my team" felt might be wrong...but it was worth it.

I wish you would get a second opinion with an orthopedic spine surgeon. At least in my experience and of several of my friends, they are more approachable and more willing to work on a back that is really messed up from multiple surgeries...not every ortho spine surgeon mind you, but there are some who specialize in revision surgeries or complex spinal surgeries.

Regarding your questions: I don't think you need to say much since it is a new patient consultation. He will ask what he wants to know about your previous surgeries. I personally wouldn't mention what the other NS told you about waiting till you blew out the disc....I wouldn't say anything about him unless asked, and then be very careful what you say and keep it all business.

Where were your fusions? How long ago were they done?

I think I would just say that you suspect your symptoms are coming from the L5-S1 level and you wondered if it has become unstable. And then find out what his plan of treatment is, what options do you have, etc. Some surgeons may be reluctant to operate again, as the risks for complications increase every time you enter that spinal space.

 
Old 03-05-2013, 07:58 PM   #3
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Re: Getting a second opinion, what should I ask?

I had my first fusion L4-5 on Feb 9, 2012 and the other L3-4 on June 28, 2012. I have been diagnosed with adjacent disc disease. I honestly don't really want to switch surgeons but I let the nurse get to me. I thank you for your advice on not letting her deter me. I guess I am in shock, cause that's not usually what they would do. They have always been very helpful. I figured he would atleast order a MRI or CT scan on my back. I am going to try calling them again tomorrow. I will explain to her that the injections don't work very well on me. I believe i herniated the disc, cause my right leg is killing me. I am also having weakness and severe muscle cramps. Thanks again.

 
Old 03-05-2013, 10:48 PM   #4
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Re: Getting a second opinion, what should I ask?

RTgirl:

I agree with the other response to your post. I really don't think it is up to the nurse to make the decision on what can or cannot be done for your medically. It is the doctors call. While the nurse may have knowledge and limited authority on what she can or cannot say to a patient I think again it is the doctors call.
And while she is basing her decision based on what you have told her as to how you feel and symptoms as to whether anything can be done or not should be based on diagnostic testing. Either an MRI or CT scan may give more information on what actually is going on.

You can go in with a set of questions on whomever you see but it is difficult to plan sometimes your questions. I would relay all your information to the doctor as to what is going on symptom wise; ask him what tests he thinks need to be done; or if physical therapy is of benefit to you based on his examination as well. Sometimes asking questions can only come about from a direct dialogue with the doctor as to treatments options; recovery time etc.

As to who to see I also agree that getting another opinion from an "Orthopedic Surgeon" vs a "Neurosurgeon" could be a good idea. I think the way they see treatment options do sometimes vary.

I know personally I have consulted with both a Neuro Surgeon and an Orthopedic Surgeon and while the Neuro was saying "NO" surgery the orthopedist was seeing that YES surgery should be done. So I was left needing to evaluate the information and what I felt comfortable with. While I don't WANT surgery I did opt for it and found that it was the right decision for me.

Good luck and just remember that sometimes it is better to have a different set of eyes evaluate you and give you a different perspective on things.

Keep us posted on how you are doing

 
Old 03-06-2013, 06:02 AM   #5
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Re: Getting a second opinion, what should I ask?

Do you have to speak with the nurse in order to make an appointment with your surgeon? I would just call the scheduler and make an appointment to discuss the increased worsening of symptoms....

 
Old 03-06-2013, 08:36 AM   #6
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Re: Getting a second opinion, what should I ask?

Well, I called and left a message with the nurse at my current NS's office. She almost immediately called me back. She told me she is going to talk to the doctor about getting me another MRI. I explained to her that I didn't want an injection cause they don't work on me very well. They were very friendly and helpful. I think she didn't even talk to the doctor the first time I called.

 
Old 03-06-2013, 10:05 AM   #7
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Re: Getting a second opinion, what should I ask?

I think/hope you are correct. For sure, she must have been having a bad day....I have really discovered from years of experience...and I didn't want to believe this the first couple years, that "they" (don't know if it is doctors, nurses, or just who...) do what they can to dissuade patients from treatment....I think they must figure that unless the person is highly motivated, they don't want to pursue further treatments. What they want ideally is a person who comes in, is diagnosed and then treated successfully, and then they would prefer to never see the person again!!

When they did a treatment/surgery that was supposed to be successful and/or relieve pain, they would prefer not seeing the person again...they will try first to placate the person...but if the person is persistent, in my experience, the doctor then is more cooperative and usually goes back to being pleasant and trying to figure out what else could be wrong.

I hope you get the new MRI...

 
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