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Old 07-05-2006, 01:57 PM   #1
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I need some advice please

Hi,
I'll just tell my story then see if anyone can give me some much needed advice. I'm waiting to get an mri (I'm going through a place here that helps the working class who can't afford insurance but needs to get back to work).
Once I get the mri the doctor is going to want to "try" injections then if they don't work on down the line he will suggest surgery.This is what he has been telling me while we are waiting for all the paperwork to get in so I can get the mri.Here is what I want to know.Can I tell him that I would just as soon not have the injections and just do the surgery?I know that would cut out his fee from the injections which is $4,800 and it would go to the surgeon instead.I am scared spitless of having injections in my neck.Do I have the right to tell him I want surgery instead?If I get the injections and they don't work then I have to go through all this red tape again to try to get surgery.
Any advice guys?

 
Old 07-05-2006, 02:14 PM   #2
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Re: I need some advice please

The choice to have the injections or not is inevitably yours and not your doctors. Doctors can not force proceedures on anyone if they desire not to have them.
Injections in general only have about a 50% chance of even being effective and much of it depends on the amount of damage you have and where the injections are done. They are only a temporary stop gap and last at the most 6 months.

Talk to your doctor about your concerns. Some doctors will do a light sedation. If he tries to insist or force them on you seek out a second opinion. It is your body and your health, you have the right to say no.

 
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Old 07-05-2006, 03:44 PM   #3
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Re: I need some advice please

Hi Marksta - You don't mention if you have a diagnosis yet. Do you know what is wrong with your back? It sounds like the MRI will be giving the doc some much needed information before a decision could be made about injections or surgery. I'm not very fond of needles myself, but having had both injections and major spinal surgery, I'd much rather try to resolve the pain with an injection first!! Believe me, the little bit of discomfort you may feel (and sometimes if you use some sedation you feel none!) is a small cost to pay for some possible relief. Why kill a fly with an atomic bomb if a fly swatter will do, right? The other issue is the fact that most reputable surgeons aren't going to just operate because the patient decides they want an operation. You need to have something wrong that can be fixed by a surgical procedure and surgery is usually the last resort. I would suggest getting a diagnosis and finding out what your treatment options are. If you aren't happy with what the doc tells you, of course you are entitled to a second or third or fourth opinion. It doesn't sound like you have any insurance so getting lots of opinions may not be feasible for you at this time. I wish you lots of luck and better days ahead! KathyMac

 
Old 07-06-2006, 07:24 AM   #4
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Re: I need some advice please

Hi,
By the way it's my neck not my back,I forgot to mention that.
No, I haven't had a diagnosis yet except from x rays from a chiro.But my pm doc says it looks like it's either a bulging disk or a crack.I know after the mri he will be able to tell for sure what will be my best options,I was just wondering if he tells me that he is going to "try"the injections and if they don't really help then possible surgery then that is why I asked the question if I had the option to say skip the injections and just do the surgery.
Bev

 
Old 07-06-2006, 07:59 AM   #5
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Re: I need some advice please

First things first,you need the mri to determine what the possible pain generators are.

are you referring to Epidural injections?If injections have a 50% chance of helping why rush to surgery.
Also if the first 2 injections do not help then go no further because its doubtful a 3rd will help.

If you are paying for the injections you should get a discounted rate for "self pay" patients.
a doctor may bill insurance for $500 an injection(just an example) but if you are paying out of pocket you pay only $275.
insurance companies only pay a portion of what they are billed for.
the price you are paying seems outrageously high for injections,especially if you dont have insurance.

If the injections require flouroscopic imagery,which is always reccomended,the cost can be much greater but it is not necessary.
Ive had 3 without flouroscopy and they only helped the leg pain not the back pain.

If you think a couple of injections are high wait until you get the bills for the surgery.

I would get the mri and then get atleast 2 opinions before considering surgery.

Bulging discs can and do heal but it can take over a year.

once you get the mri i think you really should see a physical therapist.even if you only go for a couple of visits ,being as you do not have insurance.
A PT can show you what exersizes you can do at home.stretching daily is a must and can make a very big difference.

from my own experience, and i have many bulging and torn discs along with other lumbar problems,i can tell you that after a few months of strenghtening the pain became much more managable and was so for over 2 years until recently.

surgery is not necesarrily a cure all and a broad range of conservative treatments should always be tried for atleast 6 months as long as there is no serious nerve compression which may require surgical intervention and even then you should get more than 1 opinion.

good luck and once you know exactly what is wrong the internet is a great place to find all the info you need to make a decision.
When you are in pain it seems like you have very few options and its easy to get discouraged so managing the pain is important.If medication helps with the pain and there is no risk in putting off surgery you may get better in time.

 
Old 07-06-2006, 01:16 PM   #6
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Re: I need some advice please

Get the MRI and take it from there. However, you do have the right to refuse treatment, from any Dr., at any time! Another thing to think about is this - there is also a chance of permanent damage, called Arachnoiditis, from Epidural Steroid Injections, and I am living proof of such!!!! I had 4 of these injections in 2001 and went from being in pain, to RELENTLESS, AGONIZING, SUICIDAL pain....all thanks to those injections!!!

This is "just a risk", and doesn't happen to everyone getting them, but even the maker of 'Depo-Medrol' - the steroid drug most commonly used in these injections - has included in the package insert the warnings that injecting this drug into the spinal canal can cause "Severe Medical Events". And, Arachnoidits is also now listed on this in package information as possible side effects from intrathecal injections!! Sad thing is, the patient, and general public, NEVER sees the package insert on medications..........especially injectable drugs!!! You can read the entire package insert for Depo Medrol yourself by going to Pfizer's website, the maker of the drug, and typing in it's name.

There are MANY people helped by these injections, no doubt!!! However, I think it's only fair that people be TOLD of the risks before they make up their minds!!! Also, be SURE your Dr. doesn't just simply inject you, as he/she would with any other shot. These types of injections should ONLY be done underneath the aide of a Fluroscope - a 'live', running, x-ray, to guide them as to where the needle and medication is going. You should also be taken to a Recovery Room and be monitored after the injection. ANY THING short of this type of care is NOT acceptable!!! ASK QUESTIONS before you agree to go this route!!!!!

Best of luck and keep us updated.
Sherry

 
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