Hey MH, Sorry to hear about your friend, When did they do a disc replacement in his neck? The reason I ask Is because the only aproved disc is about 3 times the size of a cervcile disc and aproved for l4/5 and l5/S1. IF they played guinea pig on him and the disc has slipped out of the plates that hold it in place, he probably has a major law suite if the surgeonis still around and he's still insured.
AS far as being able to see a slipped disc from the back side, it just isn't possible unless they first surrgeon did a total hemi laminectomy removing all the facets including the posterior spinous process. If there is a large bulge, it's more likley muscular or spondyliosis or spondyliothesis because a healthy disc is only about the size of 2 quaters stacked ontop of another wouldn't cause a softball size bulge even if it some how managed to shoot out of the spinal canal past all the vertabrea and present as a large lump. More than likely if a disc is going to move completely out of it's space it's going to take the path of least resistance and move forward impinging his spinal cord.
Vertabrea shifting forward or backwards or completely slipping off one another is called spondyliotopsis would cause a large lump similar to the hump back you see in theelderly right at the thoracic cervie junction or lumbar thoracic junction. IF this happens again, call an ambulance so that a an ER doc can see the malformation and do at least do an Xray. But in the absence of gross malformation or nerve envolvement like loss of muscle, loss of strenght,reflexes or paralysis, an ER doc is going to treat a cash customer very poorly. The medical model for first presentation of pain in your back or neck suggest anti inflamatories, muscle relaxers and rest or imobolizing the area.
Advanced diagnostics aren't step one when symptoms are presented to a doc for the first time unless there has been a major trauma, falling off the roof, MVA etc.. IF he could get back to the surgeon that cut him the first time, he's more likely at least going to get an Xray which will tell them if his vertabrea are out of whack.
I dwas watching one of those medical miracle or super surgeies on discovery one night and a guy went to bed with neck pain and woke up paralyzed from severe spinal stenosis. They decompresed the area dna after aboty 6 weeks he was able to wlak again.
Those shows get a bit depressing when your wondering where your miracle is, but if your friend applied for Medicaid on his own, wasn't prepared or didn't do the follow up , he may have been able to qualify through a medical spend down aloowance. If he had enough medical bills that would absorb his entoire income for months, that is taken into consideration.Having an advocate go with him and work on the follow up is more than likely what he needs.
It's really a catch 22 thoyugh, Had I been able to aford the 3K in meds and actually paid them out of pocket for the 3 months prior to applying for SSD that would have been taken into acount, I would have been aproved and they would have gone back 3 months and paid the unpaid medical. Unfortunately without insurance and without the eans to spend 9 K on prescriptions I gave up every med I couldn't aford and switched to methadone, So by adjusting my meds to what I could afford and paying the bills I did have, I wasn't eligable. Medicicaid and social programs =rward iresposnabilty, If I knocked my wife up 4 more time with chikldren we couldn't aford, If I stifferd every medical bill I ever had and if I had gotten a divorce to take my wifes income out of the equation, I would be lioving fgat. Folks on a full ride with medical, housing,food stamps, income benefits, live better than I do, But I don't qualify for that. My wife is supposed to spend 1/3 of her net income to provide insiurance which would make us homeless. . So untill I won my SSD case which took 2 years. and hit the 2 year point to recieve medicare, I had nothing but what I could aford to pay cash for.
The inequity and hypocricy of social services is far more than I care to go into. But I would say, if he went alone, without an advocate to help him follow up and round up everything they ask for, it's likely he would be denied. You also have to know the secret handshake.
As far as why would a doc use lortab for over a year, that's easy. Prior to 96 and the invention and and opiate explosion OxyCiontin created. There was nothing else and this is what docs provided. It worked back then and not every doc is on board with the idea that if they make it, I should prescribe it.Creating opiate dependent patients for life is on few docs agenda ond few docs see the risk benefit value or jave the training to prescibe doses that only oncologist once used on terminally illpatients in Hopsice. Now we have folks driving to work on what was once only used on someones death bed. It's a concept most GP's and surgeons whos patient do fine with 5 mg percocet for post op pain , have a hard time swallowing that someone needs 10 times the dose that a hip replacement patient needs 5 days post op.
If He wants the help needs hand doesn't have an advocate or the time to put into it, He can work the sytem like many do. Simply create enough medical bills for the spend down at the ER or through psych expenses with failed atempts at suicide due to his pain.This will crate the spend down amount in bills to make him eligable. They will have to keep hime a few days for observation, consult with a shrink and bring a social worker into the case to help him obtain medicaid so that he can seek PM and psych treatment treatment by someone familiar with the meds, tolerance and PM.
Sorry if I seem glib about the nedicaid but when you watch your neighbor spend 100 bucks worth of food stamps on 4 lobsters for their aniversary dinner, and you can't aford to put food on the table for your daughter or pay for needed meds , it does make you a bit synical.
There isn't an easy answer other than incur the bills he nees fto meet mediciad spend down amount to quaklify.
I took nothing but apap and motrin for years and nobody gave a hoot about thepain, the damage OTC meds could cause and simply went without care someone stupid enough to pump out kid after kid in their teen years is living better than I am because they were irresposnsable, it's hard not to be glib. I would have loved to have another child, but we made the decsion not to bring a child into this world we can't aford. I would love to see us make changes to the medicare and medicad system so that the govt will jelp with 2 kids you can't aford, but if you continue to have them, your on your own. Birth control is vaialbale to everyne, but when the goalis to have as many kids as possible to increase your benfits, with the lack of any moral compass, folks that continue to make a mess out of their life actually benefit more than those that do everything in eir power to live on what they do make and not make a bigger mess out of things by getting knocked up again. We aren't talking farmers that need extra hands to help out her,e were talking single moms with 6 kids at the age of 25 that live better than the working class by working the sytem.
The more kids you have that you can't aford,not getting maried to the babies daddy or identifying them to the court system, the bigger the check and more benfits your eligable for . Something is teribly wrong with a sytem that rewards being irresposnsable and penalizes those trying to live within their means that simply go without. When my wife was the manager of Rite aid, she had a P/T employee that made more money from the state in cash payments alone than she did, and that didn't count the section * hoiusing for 35 bucks a mionth and the 1600 in food stamps and free ride on medicaid for evry child and herself. If this woman married a man that made 30K a year, she would nd up in a worse financial position than she was as a single mom with 8 kids. So where is the incentive to do the right thing when it's a pattern of fraud passed down from generation to generation..
I don't mean to imply everyone on mdicaid is working the sytem, but when you have 3 kids by the time you graduate high school and plan on keep pumping them out, the goal is to never have to work a day in their life and have the state provide all their needs just sickens me.
Good luck and if your able, try and be his advocate,find out what his spend down amount is to receive medicad. He should defintely call the ambulance if he wakes up and can't move. That is an actual emergency beyond chronic pain and that visit to the ER he can't aford will aplied towards his spendown amount so he will qualify for benefits.
Good luck, Dave