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Old 08-12-2008, 06:39 AM   #1
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Question Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!!!!!

Hey Everyone,

Well the day is finally almost here. I have been hanging in there and doind as little as possible. I do think the valium has been helping some. I am not waking up with pain levels of 9-10 andyomore. An 8 every morning is better then the 9-10. I also have noticed that my sleeping has been better and I am also able to take a nap when needed. These are small improvements but I will take every little bit I can get.
I did have one big spasm incident, but I managed to get it somewhat feeling better and saved myself from having to go to the ER by nipping it in the butt as soon as I felt it surging upward in intensity.

So the day to meet with the Ortho is on Thursday. My Mom will be at the appointment with me. First off since the last time she was with me at an appointment and she kept answering things for me and interupting during me asking a question to the doc...and then me having to ask her not to do that after the doc left the room, and letting her know that I will always give her the oppportunity to ask her own questions and make her own comments. I think it would be best if I asked her to write down all of her questions she would like to ask and then I will do the same. We will cross off any duplicate questions so they are only asked one time.

The other thing is I don't reall know what to expect from this appointment.

You all already know that the Ortho had ordered the MRI of the shoulder and the EMG nerve test so I should I guess ask questions pertaining to those tests right???
I do want to know why I have so much arm weakness and numb/tingly's when the nerve test says there is no nerve damage???
Now about the MRI...we have already kind of discussed this on another post of mine.
If it come up that the ortho would like to try a cortisone injection in my shoulder what should I ask?? I do not have any pain in the part of the shoulder the MRI film took a picture of. I do not have pain in the part of the shoulder where the head of the humorus bone is accepted by the Glenohumoral joint.
Do you think it is acceptable to ask the doc what he expects me to see as far as a differnec in the shoulder if an injection is done there?

Now most of the questions that I have written down are from a long time agao and are mostly pertaining to the ACDF surgery. (Anterior Cervical Diskectomy with Fusion) All those questions were answered without my ever asking them by the PA who saw me in the first part of the last visit at this Ortho's ppffice. SO lots of things I am curious about are pertaining to the fusion surgery and are more about things such as hospital stay and pain control afterwards.

On the othe hand...even though in the last visit with the ortho the Physicians assistant did sit me down and say your neck problem are blah blah blah and then showed me the corralation with the discogram results....then explained how the problems in my neck are treated (with the ACDF) what would I sya if for whatever reason the ortho surgeon tells me that he does not want to do the surgery yet?
This is a huge fear for me! I just can not continue to live this way plus I am broke and can not possibly work in this condition.

I just feel I need to have some help in thnking of different lists of questions for each senerio. I know that sound crazy but I want to be prepared and get as much from this appointment as I possibly can!
We all know I am pretty well devastated after the appointment from last week with the Neuro so I want to make sure I get the answers I need before I leave tht office.
Also my Mom needs all her questions addressed and comments listened too.

So I guess what I am asking from all of you is anything you have to offer.!!
If you would like me to post the list I have pertaining to the ACDF surgery I can do that, but they are basic surgery questions. And they pretty much would be irrelevant unless the surgeon says he wants to move forward with the surgery at this time. He also needs to know that I have undergone all conventional methods of treatment with my PM with no results of pain relief.
Do you think I should call the PM's office and ask that they send documentation of all thep procedures I have had?? They don't need to send the whole file ... maybe a list of dates of procedures and a brief out come of one sentence.

There is not much time to get this all done but I hope oyu all can help.

Chrissy

 
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Old 08-12-2008, 09:23 AM   #2
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Re: Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!

Hey darlin',I think the first thing I would address is to ask the ortho what kind of long term expectation he has for you, regardless of how it is approached. I feel that if you start out by putting him in the position of committing (as best as he can) to what he thinks is an acceptable long-term prognosis for your particular situation, it will give the rest of the appointment it's direction or flow. (I hope that made sense, I'm a bit off my game today) If he can set a goal of sorts, I think he will be better equipped to lay out a plan to reach that goal.

Then you can continue on asking questions about any injection(s) and/or surgery. I can't really offer specific questions about the surgery, since I haven't been down that road as of yet. (knock wood) I just feel like it's so important to get one of these docs to make some sort of a committment. Not a guarantee, of course, because I know that is just not possible with any kind of surgery. But I see no reason why these docs should keep running around in circles at every appointment. You deserve to have some peace of mind, sweetie.

I don't know if this was helpful at all. As I said, I'm not well versed in the surgery end of it. I will definitely be praying for the best possible outcome from this appointment. If there is anything more that I can do, please don't hesitate to ask. Many hugs and much love, CMP/MM ((((((Chrissy))))))

 
Old 08-12-2008, 11:22 AM   #3
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Re: Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!

Is there any way to get an increase in your pain meds while you are waiting for the surgery? I think you need to be clear that you can't work or function now. If you're certain about the fusion (and it sounds like you are), I would make this [the fact that you are in tremendous pain, can't work and can barely function] part of the argument for the fusion. I've read more of your story at this point, but don't know how to advise. I would also talk to the surgeon about how much pain relief you should be able to expect after the fusion. Again, just take anything that seems to be helpful here - if it's not, pls. don't worry about it.

It does sound like your mom needs to be reined in a little :-). I think it's a great idea to have her write down her questions ahead of time and compare notes. Have you discussed the fact that she talks over you when you're asking a question? She might not realize she is doing this - It could be her anxiety/worries about you and the surgery taking over [just guessing - don't know your mom!]. Perhaps she could have a "portion" of the appt. to ask her questions? I would also try to make sure her questions don't sabotage your goals for the appt. in any way and talk to her about this. Without knowing you or your mom, hard to give much advice :-).

If I understand correctly, your greatest concern is that the ortho is going to want to wait on the fusion, right? I don't know /remember why he/they want to wait. It seems like a good idea to show that *nothing* else has worked.

If the ortho raises objections to the fusion, he needs to explain why he's reluctant or wants to wait, and what you are supposed to do instead. I really thought neuros/surgeons were anxious to perform surgery [a little *too* anxious], so I'm surprised about the delay/objections...This is where having your record from PM would help - think it would be better if you brought in your own copy so that you could decide if and when to show the ortho the results. But having it sent over from the PM would probably also be ok if you don't have a copy. I would try not to walk out of the office without some kind of "plan."

I don't feel like I've been very helpful. I don't feel like I understand the situation well enough to comment intelligently here.

Last edited by Confused089; 08-12-2008 at 11:41 AM.

 
Old 08-12-2008, 01:16 PM   #4
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Re: Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!

I think when you are in there you will have to address the way this neck is affecting your entire life. It is getting harder and harder to function - not able to attend meetings, church, go grocery shopping, sleep, etc. I think if you go in from the pain standpoint it might make him realize that you need help.

Then I would leave it up to him. I agree surgeons love to operate and will do it whenever they can. If he says surgery, I hate to say this - don't through anything at me - but I would go get another opinion. I know honey you are hurting and I have been there myself and I rushed to surgery and guess what I am 20x worse since surgery. I did not think it was possible to be worse but well here I am. You know my life story. I am concerned that you have one doctor saying no. Please, I beg you to consider another opinion.

 
Old 08-12-2008, 04:10 PM   #5
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Re: Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!

agree with dp do not rush to surgery lots of us have had horrid outcomes but at least hear him out.
As him about what scucess you can expect and or the worse case you can expect. Ask how long he will support pain treatment after the surgery, or after three months will he refer you out? If he is pushing surgery ask if he has back up plans in case there is an emergancy during procdure, As what is expected up front is it an out patient facility or day clinic?
Ask about length of time for soft collar/hard collar. What are general restrictions before afterwards.
Does he need permission from the other docs you are seeing ( i had to get 3 docs approval before mine proceded)
What are his instructions if you have an emergancy after the procdure.

 
Old 08-12-2008, 05:01 PM   #6
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Re: Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!

Everyone here has given good advice. I would ask:

1. what the prognosis is with the surgery
2. what the prognosis is without the surgery
3. what reason, if any, would there be to wait
4. if there is a wait, what he/she recommends you do in the mean time, considering you are 75% disabled (or whatever number you choose)
5. What, if any, alternatives there are to surgery
6. what complications may arise with surgery
7. how he/she handles complications
8. How many of this type of surgery has this surgeon done
9. what is his/her success rate (i.e. 80% report 50% improvement)
10. what the rehab plan would be (PT, etc.)
11. Expected recovery time (when you could go back to work)

I'm sure I have more. I'll post them if I think of them. I hope the appointment goes well. -B

 
Old 08-12-2008, 07:08 PM   #7
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Re: Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!

Oh Chrissy, Sugar this is so overwhelming that I cannot even pretend to give you any advice - what the others have said will surely be helpful - I will toss in my love and thoughts and will be on my knees praying to the Lord that things will be better for you - I am happy with your minimal decrease in pain but that is not enough to live a productive life - I am really feeling your pain huggs Ave

Last edited by Aver00; 08-12-2008 at 07:10 PM.

 
Old 08-12-2008, 07:09 PM   #8
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Re: Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!

Oh Chrissy, Sugar this is so overwhelming that I cannot even pretend to give you any advice - what the others have said will surely be helpful - I will toss in my love and thoughts and will be on my knees praying to the Lord that things will be better for you - I am happy with your minimal decrease in pain but that is not enough to live a productive life - I am really feeling your pain huggs Aver

 
Old 08-12-2008, 07:23 PM   #9
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Re: Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!

You've gotten some great advice here and I'm sure more is coming. The numbered list is really helpful - I suggest taking what seems helpful from people's advice and adding it to the list. I, too, like Zoey and Pepper really worry about going for the fusion. I know you don't feel like you have any alternatives. As Pepper said, you could hurt *more* afterwards - my pain went way up. I know you have talked with people; I hope you have also looked at the statistics. If there is instability that they can't resolve any other way, then there may not be a lot of other choices. But, certainly, if you have one doctor saying no, and another saying yes, I would get *at least* one more opinion - hopefully from someone who isn't a good friend of the neuro or ortho. There is no going back after a fusion [obvious, but I don't think it can be overstated]

Asking about pain control in the hospital and afterwards [if they give you the straight story - it's eary to say it will all be fine - I couldn't believe how much pain I was in at the hospital and afterwards - another tip - don't leave the hospital under your pain is under control - realize you are no where near post surgery yet, but I might forget to say this later - it's really important that they get the pain under control IN the hospital - regardless of what they say at the time ]. I was very under-medicated and the nurses and PA handled PM, not the doctor.

A few more things - you might feel like you need to get every question answered in this visit. You don't. I may have annoyed my neurosurgeon by seeing him 3x and talking w/ him on the phone, but I really wanted to know everything I could before going into the surgery. I had a note-taker at every mtg. (alas, not a good one) which I think is important. Could your mom be the note-taker for you? She might have her time to ask questions and then take notes the rest of the time. I would have liked to tape record but I suspect the doctor would have objected. I'm often surprised at the difference between the chart notes and what was said/done at a dr.'s appt.

If I understand correctly, PAIN is the major reason you want/need the fusion, right? I would really question him closely about how many patients have pain, and for how long after a fusion [if he's eager/willing to perform it]. I'd question him closely here if the answer is vague or at all elusive.

Last edited by Confused089; 08-12-2008 at 07:34 PM.

 
Old 08-13-2008, 07:04 AM   #10
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Re: Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!

Hey all!

Thanks so much for all the suggestions. I have taken some notes from the posts and added them to my list.

Today I woke up with the ugly high pain level but I am doing my best to get through.

I may have misscomunicated about the Neurosurgeon. In the last few visists he has said he would do the surgery but then asked me to see the ortho first...which I was fine with. Then after doing that and going back to him he was ..yes...very rude to say the least but he did say to go back to the orth se what he says and come back and see me in a few weeks and we will try to schedule the surgery.
He has just been so rude about it and saying on one hand that I have needed it all along but then makeing me jump through every hoop imagineabel and then being rude on top of it.

Both doctors have basically told me I need the Fusion at C 4-5 and C 5-6. Why the neuro is stand-offish to me I have no idea.
My Mom and I have done a lot of thinking about why he has been so rude the last fe months and I think it stems all the way back from February when I went to the Ortho for a consult without him knowing about it. Ever since then the Neuro has just gotten ruder and ruder to me. He has always said right from the very begining that I would need to be fused to address all my neck problems.
So the two different docs are saying the same thing it is just that the Neuro is not very nice about it all anymore and I will not have someone operate on me when they do not treat me with respect. That is toooo scarry tot think about.

Af for my Mom we have discussed the fact that she was interupting me while I was talking in the last Ortho visit. I told her right on the spot please do not do that I will always give you a chance to speak and ask anything or say anything you like.
I called her yesterday and asked her to come up with her own list of questions and that we will go over our lists together. SO thats the plan. She was going to be here today but I had the appointment time wrong. It is in the afternoon on Thursday so she will be here on Thurday morning and go home later Friday.

Thanks you all so much for all the questions and support. I am really trying not to have an expectation, but it is difficult.

Chrissy

 
Old 08-13-2008, 08:02 AM   #11
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Re: Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!

Just a little note. Please feel very comfortable with your surgeon. If he is being rude about having another opinion run fast. I am three weeks our of a three level laminectomy and doing well. I had several opions over the last two years ranging from three level fusion, to x-stop procedure, and the then the surgeon I felt most confident and suggested doing the laminectomy which should (95%) chance of at least buying several years before a fusion. I was very comfortable with him and his staff(this is very important as the pa will be your best friend during your recovery.) The first neuro I saw was a little defensive about getting other opinions which made me very leary of him. Do have all your records and mris,cat scans,and questions ready for him(or Her.) You didn't say how old you are but try to be your own advocate only you know how you feel. My husband was with me during my appts but as support and a note take which worked well.

patti

 
Old 08-13-2008, 08:13 AM   #12
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Re: Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!

Chrissy, I wish you well at your appt and I think it is a good idea to go in with no expectations. I actually went in to my appt on Monday knowing that she was not going to help me and look what happened she was so compassionate and shocked at the lack of treatment I have received SO one never knows. I only want the best for you.

Blessings and prayers for you.

 
Old 08-13-2008, 08:29 AM   #13
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Re: Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!

Chrissy,

Do you need anything more from me?

I am trying to follow everyone's posts and such and have failed to be here for you on this one. It seems every time I sit down to read the board my HAs get worse. I think it's the reading on a relatively bright screen.

Anyway, I am here for you. Please don't hesitate to ask for anything.

I will try to look here regularly throughout the day today.

If you need something urgent, start a new thread and entitle it "Steve Help" or something like that, OK?

steve

 
Old 08-13-2008, 03:37 PM   #14
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Re: Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!

Chrissy,

Checking back.

Sorry we've missed each other.

I will be on tomorrow morning at around 7am PDT, so if you have anything you need from me, and that will be in time to help, please post here.

steve

 
Old 08-13-2008, 04:23 PM   #15
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Re: Ortho Surgeon Appt. Thursday. What should I ask and say or not say?? Please Help!

I agree that it's a good idea to know what the plan is for pain control right after the surgery. I did not get good pain control after my fusion. It was scary, and I did not get any sleep the whole night afterward because I was in so much pain. I had to beg the nurses to give me something. I wished I would have discussed this with my doctor beforehand. If you are already taking some narcotics, you will probably need more pain meds than the average person. I really hope the appointment goes well tomorrow. You will be in my thoughts.

 
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