question about neurosurgeons

  • Thread starter Thread starter ladybug8372
  • Start date Start date
L

ladybug8372

Guest
i know that after a surgery....you can and most likely will be prescribed physical therapy......my question is...........will they prescribe it before doing any kind of surgery if asked??

long story...but short version is....injured at work 18 months ago...initially given 6 visits of PT...which at that time i was in really bad shape...so most of that consisted of heat/electric therapy...and teaching me the correct way to sit, stand, get in bed, out of bed, etc.

it took a few months before i could convince new dr to put me back into therapy....then i was allowed 10 visits...woo hoo!!....then....was referred to a surgeon....and have been without a dr while waiting on that appt.....took them 9 months to get the appt made............so in my opinion...i was not given a fair chance for therapy to work...and do not want to be told that i HAVE to have surgery until i have been given a fair shake at physical therapy..for more than the obvious reasons. i have gained weight and am far more out of shape now than i ever was, since i was without a dr for so long and didnt know what i could/couldnt do.....so the last 9 months (well...if you want to include date of injury...its been 18 months)....will very little activity. my husband seems to think that he will not prescribe pt before surgery...since surgery is his specialty and how he makes a living. im just scared that im gonna be forced into a surgery that mentally and physically i am not ready for..........and honestly...ive lived with things this long...and have adapted to my limitations.....i dont want ANY surgery. but if dr says so....i HAVE to do it....or wc has the right to cut off my benefits.
 
I can totally understand your situation, as I am about to see a specialist for a 3rd surgery. In VA, it is the same as your state, if you turn down treatment that the Dr. and W/C want you to have, it is seen as you are not wanting to get better and they can, and my lawyer said she has seen them drop you from their system. However, in VA, you do have the right for a second opinion. Also, most surgeons would prefer to do conservitive therapy prior to surgery, even though this is how they get paid. My surgeon sent me to P/T prior to surgery. He then told me that if this did not work, he would prefer not to do the surgery, until I was at the point of not being able to take care of myself. So, honestly, his intentions were for my best and not to line his pockets. It can not hurt to ask his thoughts on another round of P/T, esspecially if you tell him that you thought you made some progress in the past and also with the weight gain...tell him that you have read the studies that show over weight patients often do not fuse and you were just wondering if he might refer you to P/T one last time, and them if you were still not better, you would agree to surgery.

I don't know if you have a w/c case worker, that goes to the Drs. appnts. with you, but if not, you can feel comfortable asking these questions. The rule about having to accept what w/c wants you to do, will only be the case w/ you following through with your Drs. final referal. So, if your worker is not there with you, feel free to talk to the Dr. about your concerns, since the worker won't know of your conversation with him. They will only see from his report, what his/her final outcome was, whether in the end he suggested surgery or P/T. They won't know that you suggested the P/T, just that is what he is referring you to.

I was a little confused about one thing. It looked like you said you did have another 10 sessions. Are you thinking you needed more than 10 sessions, or is it because so much time has past since then and you want to try it again? Also, do you think the last round of P/T worked, even a little bit? Make sure you tell the Dr. if you think it worked. If the Dr. thinks that it did nothing for you, he probably won't want to refer you to it again.

Good luck and keep us posted.:angel:
 
lfoster21........well at least knowing that neurosurgeons can and will authorize pt and try conservative methoRAB first before mentioning surgery makes me feel alot better. my hubby didnt think they would prescribe therapy until ive had surgery...because thats how they make their living, so he felt that given that i am being sent to one...conservative methoRAB were done with. (not that i ever really had much "conservative" treatments!)

I do not have a case worker..and even if I did, they are not allowed in the exam room with you. They have to wait in the lobby while being examined, then after the dr is done with you...they can come in and listen to his findings/recommendations. So that isnt a concern of mine..thank goodness!! My concern is trying to get almost 2 years worth of info in....most especially the last 9 months of things that have gone on, and no dr to tell it to...within the time frame that I will have. I dont know how much time I will have...but if like any other dr..I will be lucky to get 30 minutes with him..so...Im having trouble figuring out how Im going to get everything said within a short amount of time, plus have time for his exam.

as far as pt visits...in the beginning of my injury, i was authorized for 6 visits...once that was completed, i was in between drs...so had no one to authorize more visits. a month or so later..i had a new dr...and it took me 2 months to get that dr to prescribe more pt...and when it was given...wc only authorized 10 visits..once those 10 were completed....this dr told me "goodbye". so i had no one to prescribe more visits. i have no idea if it helped or hurt. the therapist wasnt getting anywhere as far as manipulating the disc back into place and getting it off of the nerve...but...whos to say that it wouldnt have happened if i would have had 3 or 4 months of good therapy sessions?? i just wasnt given a REAL chance to see if therapy was really going to help or not. 10 visits just isnt enough to accomplish much of anything. does that make more sense now? most people i talk to say they had to go through 4-5 months of therapy 3 times a week..........i got 10 visits!! (basically speaking..3 weeks of therapy and i was DONE!). im sorry...but 3 weeks just isnt enough for anyone...thats like exercising for 3 weeks and expecting to be able to run a marathon....it just isnt enough! thanks for your help...you really put my mind at ease!
 
honestly?in my personal experience in seeing three different neurosurgeons,i have never had one that didn't fully discuss other options OTHER than to go right to a surgical option.once any surgeon does any surgery on you ,you naturally become their responsibility and also a possible liability too,you know what i mean?most,espescially if you ask directly,will give you the PT or any other options that could possibly help without needing surgical intervention right from the start.in your particular case,since their is a wieght issue,they may actually encourge it since some pain increases can come just from added wieght.it doesn't help,that much i know.my hubbys low back pain has become much worse since he put on alot more wieght over the past year.it really can create its own little paincycles or exascerbate preexisting pain issues espescially when it is spinal.it causes kind of a 'pull' forward of the spine.

one other possible PT option is to just get a referral to a doc called a "physiatrist' this is not a physc type doc but one that has a really extensive overall knowledge of muscle/nerve and setting up the proper rehab type treatments for patients with pain problems too.or a physical medicine doc would be good too.but the NS could also give his or her recommendations to you from a more personal/medical standpoint and let you know if surgery would be a good idea or PT.as long as you go to a good reputable neurosurgeon you shouldn't have to worry about the surgery as your only option type thing.i just think you would really obtain the most overall knowledgable medical surgical opinion in seeing the NS.this has just been my ongoing experience with NSs.good luck and please let me know how you are doing.Marcia
 
That is good that you don't have a case worker with you, so you can talk freely with your Dr. This is what I do, when I have an appnt. with my PM dr. (which is once a month).

I type up an easy to read, 1 page paper, that has 3 sections and ea. has a header typed in bold. 1. Things that I have tried, since last visit (meRAB, excercise, new routines etc.) 2. My concerns (In more pain, have had to cut back on work hrs., can't sleep through the night etc.) 3. Any questions I need answered.

I type a short paragraph at the top of the page, stating that I will be seing him in a couple of days, and you thought that this would help to make the appnt. go quicker if he knew in advance the questions and concerns that I was going to talk with him about. Tell him your doing this because you always forget to ask your questions, so it is not because he rushes you. (you want to stay on his good side:)) I make it sound like I am doing him a favor, because I am not leaving basically, until I have all my answers, and this way you are helping him to speed through the appnt. by already knowing your questions. Then I fax it to him the day before my appnt. (Find out what days he is in the office. Send it to him the day that he works, before your visit). Then take a copy with you to the appnt. When he comes in, you will have them in your hand, and my Dr. always asks if I have something for him. (Remeraber that often people come with forms that need to be filled out for work or school etc. so by you having papers in hand, won't shock them and he may reach out and ask if they are for him.) Then you can ask him if he received your fax. If not, give him one and tell him that you always seem to forget to ask him questions, until you get home. So, you were hoping he would go over these questions with you.I have found that now when I go in, I don't even have to fax my questions ahead of time. He just expect me to come to the visit with them in hand. He has never rushed me through an appnt. since I started going to him.

Re. the P/T, my W/C will only auhorize 12 weeks of P/T. I got 12 wks. at the 3 mo. post surgery 1, just after surgery 2 (due to problems with surgery) but when it came to my 3 mo. post op for surgery2, they denied it, stating that I got my 12 weeks just after surgery (even thought he Drs. all said that 1st P/T was for something totally different.) Now I have a friend who had surgery on her ankle and has been in P/T for 5 mo. now and she told me that her Dr. says he will keep her with P/T until she is completely better. There is no time limit. So, I was wondering if your frienRAB that have had P/T were with w/c or under their own insurance.

Also, (sorry so long;)) the Drs. that are discharging you, right after P/T is over, are they W/C Drs. Are you the Pain Management Drs. or are you talking about the surgeon? I don't know why you don't have a Dr. to treat you on a regular visit. Once I did everything that my surgeon could do, and I was still in pain, he said that there was nothing more he could do for me, so he was referring me to a Pain Dr. I will be with the pain Dr. probably for my life time. Also, once I got to him, he was able to refer me to more P/T.

Lorie:angel:
 
i actually did see a physiatrist.....they was a total joke....but then again..that dr is FOR wc..not the patient. i had to BEG them to put me in pt for the 2nd round of it...and once my 10 visits were up...they released me as their patient...saying that i was "cured". but a month later..i HAD to go back to them..thats when i was referred to the surgeon. im only about 25-30 pounRAB overweight...so not a major issue...but its enough!! so im praying that he will agree to send me to pt. from what ive been told about him...hes the best out there. i am totally against surgery...but if thats what he says..i am at his mercy...because if i refuse, wc has the right to stop my benefits. from all that i have read on here....i feel that id be better off just as i am right now. ive learned to deal with the pain and limitations...so as long as i can live with it....im going to "postpone" having any kind of surgery as long as i possibly can.

i dont know what the normal length of time to have pt is...but ive read where some have gone through it for 6 months.....that sounRAB like exactly what i will need after not having been very active for 18 months. thanks for your reply.
 
lfoster....I have typed up everything so that it will be easy for me to read..or for him to look at. I dont want to fax it to him, or give it to him to keep...because I do not want it to be a part of my recorRAB....because wc is entitled to see my medical recorRAB. I dont want them to know that Im against having surgery or other things that I have to say about them..just so that nothing can be used against me. He might would put things in my record that I say......BUT...as long as I dont give the actual paper....it will only be he said/she said type of ordeal. Yes, whatever I have to say is the truth...but wc would have a field day with me if they knew that I dont want surgery and am willing to talk the dr into trying whatever else is out there for me to try. They are just that horrible to deal with. With wc, you have no rights...you have to do as the dr suggests....and if I give proof of any kind that I am against his opinions then Im screwing myself.

yes, it was a wc pain management (physiatrist) dr that I had been seeing and that released me. I had no other dr at that time...just them. I havent seen the surgeon yet...I will see him the first time next week. I havent had a reg. dr to see me for so long because wc kept delaying to get things done to get the appt set up for the surgeon appt. And because I was referred to him, and because the pm dr had released me from their care, the pm dr was no longer my dr...so Ive had no one to go to for the last 9 months....

some of the ppl i know that had pt were on wc....some just reg. insurance. but as you said...at least 12 weeks worth of pt is prescribed....i only 10 visits...which equaled 3 weeks. (plus the initial 6 visits that i got in the beginning of the injury, which was an additional 2 weeks). i dont understand what the difference is between wc and reg. insurance....if the dr says pt is needed....i dont care how many visit it takes...they should to allow whatever the dr prescribes and deems necessary, so that it will help you get better so that you can return to work asap. but.....cant say that they have even tried to get me back to work....heck i wasnt even able to see a dr for 9 months...lol. they have not tried at all to get me back to work...so basically...they have been paying me to sit at home for the last 9 months..thats the ONLY positive thing about this whole ordeal.
 
I understand completly, believe me. For me, I am allowed to fax my ?'s, only because my i/c only receives the drs. report and nothing else in my file. But if that is not your case, I agree with you whole heartedly...they are rotten and will lie or cheat to get what they want. The other thing you can do is to take your outline with you to the appnt. and tell the Dr. you have a few questons, and then go over ea. ? that is on your list. W/C should not be interested in your questions...just if you deny your referal from the Dr. You have every right to ask questions. You don't need to come out and say you don't want the surgery...instead ask questions about the studies you have heard about and wondered what his opinions are. Ask him what his opinion is on 1 more session of P/T prior to surgery (not that you don't want the surgery, just that you want to be in peak condition for the surgery). All the Dr. can say is that he believes surgery is best. Then at least you did your part by asking the questions.

I too was shocked when I learned from my friend that she was still in P/T. When i asked how long she thought she was goint to be with them, she said her Dr. said until she gets better. I find it absurd to put a specific no. of sessions that you are allowed to have, regardless of your condition. It makes no senes..obviously they are trying to save money (and could care less about our health or well being) but they will sped more money in the long run by not giving us the care we need. I, for example, becasue I did not get my P/T 3 mo. after the surgery, I now have permanent SI joint dysfunction. I would not have had that if I had anothe 12 sessions of therapy.

I am keeping you in my thoughts and prayers.

Lorie:angel:
 
Hey Ladybug,
In my state...I was told that you have the right as a patient to make the decisions regarding your care. They can't make you have surgery and they can't deny your benefits if you decide not to have it.

Deb
 
Hey Deb,

I have never really gotten a true answer on my state for it. Ive asked my attorney when I was first referred to the surgeon 9 months ago...and he told me not to feel pressured about a decision until i see the dr first, then see what he has to say....then go from there. but from what ive been reading on my state website...any refusal of treatment can result in termination of benefits....so if Im understanding things correctly......I wont have a choice :(
 
Back
Top