SI injections workers comp

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bmsammler

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My wife has injured her back at work. Although she does have a pcp and regular health insurance she was sent to a redicare type clinic and was eventually referred to orthopedics. She has had very little dr contact there and most of it was negative. She has spent about 1.5 hours per week in pt for the last two months. She did stop taking meRAB because of sever hives and mouth and throat swelling. When she told her Dr this she was told that she was bringing it on herself. When the Phys Therapist observed it she made some phone calls and told her to stop taking the meRAB. Two weeks ago she was referred to a pain clinic who gave here the 6 most painfull shots she ever had in her life. (diagnostic Nerve block) There was no positve result from this. The dr did not contact her afterwarRAB but simply scheduled a SI injection. We do not feel comfortable that the PT was appropriate or adequate, that the orthopedics office worked well for us or that the pain center is being upfront about what they are doing for procedeures. She does not want to be one of their permanant customers. Question: Can and should she go to her PCP for a sort of treatment intervention and seek second opinions?
 
Earlier in the pt she had some reactions incl facial and throat swelling. She told her dr but she said she was doing it herself. Her face was swelled up really bad one day and the therapist told her she could be having a reaction to flexerol and valium so she stopped taking both. Once again she told her dr who basicly just shrugged and said ok. This gets back to the original question if the care before needle thrapy was appropriate without an anti inflamatory. You see, there is just too much. We are going back to her primary care this week to try and get some answers. Also demanding an appt with the dr for he does any more shots. We may delay treatment to get a second opinion. Thanks again to everybody who has looked at this and given it some thought.
 
Whew...I'm glad they did the MRI :) Treatment without an MRI would have been bad medicine. If you get her recorRAB and put the MRI results on here you can get some feedback. Remeraber that W/C is not working for you but the place where your wife works. If she does not continue to improve I would get someone else to look at her and her MRI to make sure that nothing is being "overlooked". If the PT is helping, then hopefully this is a relatviely minor issue (although pain is never minor) that can be resolved with rest, PT and pool therapy. Please keep us posted, we care!

Deb
 
did you get a copy of the MRI report for yourself?? if not...get it. sometimes drs dont tell us everything thats in our reports...most especially if its wc related!!! im sorry...but it definitely sounRAB too much like a disc/nerve problem. i really think you need a second opinion.
 
Hi "B",
Sorry to hear that your wife is having a hard time. In Va. W/C must give you the name of 3 different doctors and let you decide who you will go to. I'm not sure how it is in your state. Go to your state's W/C commission online and research what your rights are as a patient. Again...in Va. if you go to a nonapproved W/C doctor (such as your PCP) it may negate her W/C benefits. If her injury is bad and she is going to need long term follow up care you may need to get a W/C lawyer.
Can you tell us more about your wife's injury? What tests she has had and what the results are? If you have not gotten a copy of all her medical recorRAB so far please do that ASAP. Your wife will likely have to be her own advocate for proper care. If you post her test results on this forum lots of people will give you their "non doctor" opinion! :) but believe me there are people on this board who have been through it all and give you some great advice.
Good luck...tell your wife to come and visit us! This is a great place for those with back problems!

Deb
 
Please bring your attention to the Posts that are Pinned or "stickied" at the top of this forum. Questions regarding Workmans Comp and or Social Security belong in the Disabilities forum.
 
First steroid injection was Mar 10th. Relief lasted from about the 12th-26th. after which the pain came back with vengance. have contacted pm dr to hopefully move next appt up from the end of april. At this point pain levels are 8-9 and she is pretty much bed ridden.
Updates will be posted as we are aware that alot of people look for information and similar experiences. Would love to hear from somebody that pulled out of this type of experience.
 
Hello, I am so sorry that you and your wife are dealing with pain and with W/C. I too am in VA and are with W/C and let me tell you to note every conversation, get all of your reports as they are done, write down all your questions and either fax them to the Dr. the day before your appnt. (or take it with a copy of it, the day of visits). This way, you know the Dr. will not leave the room, until all the questions are answered.

You may not need a lawyer right now, but as time goes by, you will. I have heard people say they don't want to have to loose their money at the end, if they can do it alone, but I will tell you I am 1 that went w/o 1 of 1 1/2 years and when I got one, she found a lot of mistakes that I was not aware of. The good thing is that you can usually get a consultation for free, so I would take advantage of that.

There is a website with state specific info., but I don't think I can give websites on this board. If you ask specific questions, I will look them up under N. Jersey, for you.

Good luck and keep us posted.

Lorie:angel:
 
If you get a copy of her MRI, do let us know what that says. Good luck and keep us posted.

Deb
 
Thank, The only thing she has had so far were the six nerve block injections down the bottom of her spine. The injury came from an unnatural movement while recovering from a slip on ice. The pain is burning in the lower back and shooting pain down one leg often accompanied by spasms.
Thanks
 
Hi! I can totally sympathize with this kind of pain. I have suffered with sacroiliac pain and pain in the lurabar facet joints over the years. What has helped me have been the sacroiliac injections, and radiofrequency (pain nerve burning) in the lurabar facets. With the SI injections, I had 3 injections which were 2 months apart-after this series, the pain got better. I have also had the RFA-which is like the medial branch blocks, but lasts longer. They burn the pain nerves, and it lasts about 8 months for me, and can be redone. What your wife's doctor is probably trying to do, is to pinpoint exactly where her pain is coming from. It is a frustrating process, but by doing the different shots, the docs figure this out by a process of elimination. Let us know how she is doing. Take care, Kera4
 
Thanks to everybody, we do have an atty and I have copies of the mri. Maybe I'm just paranoid but I get the impression that workers comp is paying these people to skewer her until she says it dosn't hurt anymore. The first time they said she was going to have concious sedation and wouldn't remeraber a thing but it wasn't the case. She remerabers it as the most horrifying experience of her life. Can workers comp widthhold sedation by saying it's not absolutely neccassary and refusing to pay for it?
 
Giving 6 injections (OUCH :eek:) without having an MRI with contrast to determine what the actual problem is does not sound like a good thing. I think everyone on the board will agree with me (it's a little slow on the board on the week-enRAB so you'll get more input, usually on Sunday nights). "Burning" pain, pain that goes down your leg and spasms is usually indicative of nerve compression, and nerve compression USUALLY comes from a disc issue. Your wife may not get any pain relief since the docs really don't know what they are treating. If I were you I would insist on an MRI with contrast to determine what your wife's problem actually is. How long ago did this happen? Is her pain the same, worsening ? Is she able to work?

Deb
 
I know in VA, once a procedure is approved by W/C, they have to pay for the entire thing, incuding the sedation. Have you considered finding a new PM Dr. I have had 2 because the 1st one kept doing things that hurt so bad and now I have one, that still the injections etc. hurt and some bad..but ea. time I have one, this Dr. goes slowly and tells me to let him know when the pain comes on and he injects me with more local A. and then continues on. In fact, when he did the RF, which is where they burn the nerves, once they get to the nerve and start to burn it, it has to be kept at that "degree" for 45 second. When he did a few of them and it was getting pretty sore, he asked me if I could hold on for 10 more secs. etc. A couple of times when I said no, he turned the heat down. So, although I have had to endure pain with many of the procedures, his bed side manner helps to calm me, he talks me through it, ups the meRAB when he can and if all else fails, he has stopped the procedure.

In his notes, it should say how much meRAB he gave her during the procedure. Look for that and post it...perhaps others, such as myself, could see how much meRAB. they got for the same procedure.

I also have my Dr. px. me valium to take prior to the procedure. Does your wife do that, as well?

Lorie:angel:
 
update, Primary care did affirm that she should have the SI injections and that she is confindant in the PM dr. First round of SI injections were the other day and after begging for extra sedative not nearly as bad as the medial branch blocks. The initial nurabing agent offered a little relief but at this point she is in more pain than normal. We understand that these treatments can take a week or so to kick in. still praying for the best. will post update in a week or so.
 
I too have been dealing with SI dysfunction and facet arthritis for 3 years now. My SI dysfunction has gone too long to be able to fix (at least from what my P/T said) but she told me that if I had seen a P/T in the beginning, they could have tightened up the socket area and after that, if and when it popped out again, I would be taught how to pop it back into place on my own. Anyway, I say this because I don't know how long your wife has had this problem, but has she seen a P/T for therapy on it? Also, if she has the radio frequency on the are, ask her pain management Dr. if she can have P/T immediately afterwarRAB. My PM said that they have seen the RF lasting longer, if followed by P/T.

Best of luck,
Lorie:angel:
 
sorry she did have an mri a few weeks ago but it had no indication of anything unusual. She also had a hip xray with the same. The injury occured in mid deceraber and gets a little better after pt which is 1 or two times a week for 45 minutes. She really likes what she calls "hang time" in the pool. They did giver a lower back brace yesterday which provides some relief. Thanks for your attention.
 
Hi,
I hope she will feel better in a few days. Unfortunately most of the treatments that are supposed to make us feel better, make us feel worse first. Take care and keep us posted.

Deb
 
PM Dr reccomenRAB another SI injection. This time nerve block only. If confirmed to be followed by RF denervation. Seems to me that another steroid injection or two would be the SOP but she wants to go ahead and trusts the doc. Great temporary relief with a tens unit.
 
My PM doctor also did a 2nd injection, even when the 1st one did not work. He told me ahead of time that if the 1st one works, they continue. If it does not, they try the 2nd one. If that one does not work, then they do not do the 3rd one. Maybe this is the normal protocol.

Good luck and I hope it works. The RF does work really well for some people.

Lorie:angel:
 
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