I donít understand why the physician assistant that I see at the pain clinic doesnít want me to have an MRI of my neck!???? I thought one had already been done by my neurologist but I just found out it was only of my brain! I was in a car wreck years ago and suffered double whiplash. I have had x-rays but not an MRI, is that unreasonable to ask for??? I suffer with daily headaches and sometimes migraines. (Since Nov. 99) What if it is something they can fix?? They have already given me a diagnosis saying that I have problems with C1&C2 which causes pain from the nerves. (This was figured out from my physical therapy, shots, trying every med in the book and what I have described.) I am on the 100 Duragesic patch and Dilaudid for BT. Yes the meds help tremendously but I don't want to be on them forever if possible!!! I HATE being dependent on them!!! I can already tell I am either getting tolerant to them or my pain is getting worse!
I CAN'T STAND THE WHAT IF?!?!?!?
Just FYI he says "I just don't see any need for it"
Edited: Any suggestions as to how I can justify getting one would be really helpful!!!
Try a different doctor like a Nuerologist or Nuerosurgeon. If the PA won't order one then ask to speak to the actual doctor and explain that you feel it would be appropriate to have an MRI of your neck as you are interested in finding a solution to the pain and not masking it by medications.
Again, if that don't work go to a different doctor.
I agree with Kissa. I would ask another doc. What about your GP? Could you see him and ask to order an MRI? Its not like they have to pay for it....
If it were me, I would ask the PM doc himself and if that doesn't work, I would go to my primary care and explain the situation. Ask him to order one. If it comes back clear then no harm no foul. But if there is a problem in your C-Spine, then its probably best to see if it can be fixed sooner than later.
I agree with Kissa too. I had something kind of similar happen to me. I'm seeing a ortho dr. I had an x ray. They saw nothing on it. Sent me to PT. This was while I was seeing the PA. Then I saw the actual ortho doctor, and he sent me for an MRI. I had a whole mess of stuff wrong with my shoulder. I need surgery I wasted all that time and all along I should of had the MRI straight away!! The PA there also gave me a shot in the wrong spot. Nothing against PA's they can be great. Some times seeing the doctor about certain things is more helpful in some cases.
Last edited by Wingsoflove; 05-16-2006 at 04:19 PM.
Thanks for all of the responses and ideas!! I am really trying to stay on his good side because I fear making them upset will get me booted out. I first started going to this clinic because they were the only place in town to treat headache patients. The x-rays showed some problems but I guess there isn't anything to do about it.
The PA said I have cervicogenic headaches and when they get bad enough they turn into migraines. They have in-house physical therapy. From the PT they decided the problem was around C1 & C2. I had occipital nerve injections and they didn't do any good at all.
I totally agree here with what everyone is telling you,see another doc about referring you for that badly needed MRI.I really cannot understand why any PM would not want you to actually have one but would rather just Rx you some pretty strong opiates??? you DO have a very real need for one.you need to know what else may be lurking inside the c spine that could also be contributing to your symptoms,it could be something totally unrelated to what they have actually Dxed you with.you just really need this done to find out for sure.at least it would rule it out or in as a possible issue.
In my case,when ever i have any sort of an issue with any of the five seperate specialists I have to see for many seperate medical issues,it always falls on the primary doc who really IS the ultimate co ordinator of your healthcare.luckily,mine has been wonderful when he has been needed to help me deal with an issue with one of my other docs.this realistically should be the guy to go to for this.i am sure he would totally understand why you need this done.
Just make an appt with him or her and sit down and really explain and discuss all of your very real concerns.I would seriously doubt that after speaking with him/her that they would deny you the referral for the MRI,really.good luck and please keep us all posted on just what you find out.marcia
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.
I agree with everyone. While I was fortunate enough to have an MRI on my neck done, my regular physical didn't look at it herself, just read the report and said nothing was wrong except some athritis and ddd. Until I saw a pain specialist recently for my headaches did I get the correct diagnosis--he saw bulging discs in the MRI that someone else missed. So, until you get what you need, keep pressing for it--it's your body. Pain pills like you are taking did not help my headaches either, they are caused by nerve damage. I have now been headache free for over a month. I'm not cured and still have pain in my neck and shoulders, but we are are the right road.
Hey Drew, This PA is so overstepping their boundaries. Honestly, if I need medical advice or an opinion, I'll wait for the doc even if it pisses the NP or PA off. I wouldn't except one of their opinions as that of a docs untill I hear it from a doc. I'v e had NP's tell me my dose is too high and nothing can be done, only to wait for my doc to come in and mak a 50% increase. NP's and PA's are fine for maint and collecting follow up information, but if you need anything other than what the doc has already spelled out in your treatment plan, the PA has no biz putting up road blocks to finding an answer or even giving you his opinion. How many years in medical school did he spend, where did he do his residency in orthopedic surgery and radiology?
You don't have to except a NP or PA overstepping their bounds which shouldn't go beyond helping manage stable patients by continung on with a treatment plan your doctor created.
Ask to see the doc if the NP isn't able or willing to help you, they can't make med changes or order daiagnostics without the docs OK, so what are they doing denying diagnostics or med adjustments they aren't allowed to make anyway. Unfortunately some like to throw their opinion in when it may completely contradict the doc they work for. Your doc didn't deny the MRI, a PA did which is absurd.
I did happen to see a story on TV a few days ago about trigger point surgery for whiplash and how succesful this one doc has been. I just did a search and I'm not sure this is the same doc, but it is the same surgery. You might want to look further into it or be evaluated for it. That is, if the PA thinks it's a good idea.