[Rose76]

I came out of seeing a doctor today with a piece of paper that says, after "Diagnosis," Cervical Myofascial Pain. He was a neurosurgeon. I've had X-rays and an MRI of my neck. I can't find my print outs of the results, right at the moment.

I was expecting him to explain to me that the deteriorated discs and the bone spurs on the vertebrae were related to my neck pain - that is causing me major quality of life issues. (I had no pain today, when I went in to see him. I've achieved that by doing next to nothing. It's not a way that I want to keep living.)

I was surprised at what I heard. If I understood him, and I'm not sure I did, he was saying that this is a muscular problem related to posture. He seemed to be saying that the pain was not related to anything wrong with the cervical spine.

I have numbness in the fingers of my left hand. He said he didn't know what that was from, but it seemed he didn't connect it to my spine.

The MRI shows a narrowed foramen on the left side. I just can't believe that it is a total coincidence that I have this funny feeling in the left hand and the MRI happens to show more pathology on the left side of my cervical spine. He said that my fingers are not truly numb. I guess the correct term is paresthesia. Though he didn't say that, either. Regardless, my fingers feel funny - like how my lip feels after the dentist numbs me when I'm getting a cavity filled. For 2 months, last Spring, my fingers in that hand were very weird feeling. He didn't seem to find that interesting.

He did seem to find my psych meds interesting, and asked about those. Now I wish I hadn't even written them down. I am probably getting neurotic and paranoid, but I just don't trust what I heard.

I made the mistake of saying that what he was telling me didn't make sense to me. What I meant was that I was having a hard time understanding what he was attributing the pain to. I didn't mean to be argumentative. His response was that I maybe I should see another doctor.

He's a neurosurgeon. I went in there expecting to be in awe of him. I'm sure he must be an awesome doctor to be in that specialty. I didn't mean to convey doubt of his ability. Mainly, I wanted him to help me understand what he concluded and why.

Like - when I said to my auto mechanic, "I don't know what you mean about how the brakes should have had the rotors rotated, and I don't see what you are showing me when you point to the black stuff." (I don't know what a rotor is.) The mechanic didn't take that as an insult. He was telling me stuff that I literally didn't understand. He tried to explain more, and I told him that was okay . . . "just do what you think is necessary." When I go back to have my brakes checked again, as the shop said I should do in 30 days, I'll bring my brother, who can translate what the mechanic say to me.

But, if I don't understand the doctor, and I happen to be a nurse, then what can I do to better understand? I don't have a brother who's a doctor that I can bring back to the neurosurgeon's office when I see him again in May. He is getting me in to PT starting next week. I suppose that's all that matters. He said PT would be the starting point, regardless of what was the cause of the neck pain.

He said that there is nothing permanently wrong with the bones in my neck. He said they will go back into position when I strengthen the muscles and work on posture. I have kyphosis at the CT junction. That is NOT going to go away. I am totally confused now.

Also, since I can see a deformity, just by looking in the mirror sideways, I felt that maybe they need to do some imaging with me standing. Other doctors have said, 'Yes, you have and area of kyphosis." He said "No, lying down is the best way to x-ray the neck." Another PC member told me about gettin x-rayed while standing. So I'm really skeptical now.

He was very young, and his way of examining me seemed not all that organized.

I told him I have a lot of anxiety about this. He indicated that that was a lot of my problem. I feel like he discounted my concerns. I feel he was dismissive of what I wanted to talk about.

Maybe, since he's a surgeon, and I agree with him that there is no indication for surgery . . . maybe he figures that he doesn't want to spend much time on me. He said, "I have other patients to see."

I have felt so hurt and invalidated. I should have stuck to a script. I should have written down all I wanted to ask. AND I should have made notes on what he was saying. I am very depressed now.

I hoped he would have said, "Okay, I understand that you have recurring distressing pain and that must be hard on you. Let's talk about the cause and the remedy." I feel like the communication between us got all confused. Even if I'm neurotic, is that a reason for him to be flippant with me? If anything, that is a reason to give a more patient explanation and more reassurance.

Now, I think that there must be really something wrong with me that I would evoke the kind of response that I got from him. Like I must be the most obnoxious patient.

When I worked as a nurse, I got along very well with doctors. I got my questions answered very well. Maybe, as a patient, I'm not supposed to ask too much. Then I think that where I live is not the Mecca of good medicine. (Also, I've seen doctors make lots of diagnoses that I was not convinced by and that turned out to be wrong.)

[Rose76]

I feel a lot better now. Something about this doctor, described in my post above, just did not inspire my confidence.

So, I looked up his credentials.

He is not a neurosurgeon. He is not an MD. He is an OD (doctor of osteopathy.) He is trained to administer acupuncture. His specialty is rehab.

I don't wish to undermine any faith that anyone here might have in acupuncture, or Osteopathy. I happen to not be the least bit interested in alternative medicine in any way, shape, or form. (Probably, that's just a prejudice.) I would never have gone to this appointment, if I knew his real credentials.

When football players, whose bodies are worth a lot of money, get spinal injuries, they don't go to Doctors of Osteopathy.

My boyfriend had cervical stenosis with myelopathy. Due to my dogged persistence, he got referred to a real Neurosugeon. I had no trouble discussing things with that doctor. Now, I think I understand what happened today between that OD and me. We are coming from different disciplines. He had even recommended me trying chiropractic treatments. MDs are slow to do that. Now I understand why he wasn't.

When I left there, I kept saying to myself, this guy doesn't strike me as a doctor, let alone a surgeon. I thought that maybe he was a Physician's Assistant. Though those guys are usually pretty sharp. Well, now I know. Now I think I know why his assessment seemed rather disorganized and amateurish. Again, I'm sorry if this offends anyone who has had great experience with alternative medicine. I'ld love to hear, if you have.

[Fresia]

((((((Rose76))))))))
I am SO sorry to hear about how things went with this appointment and not getting the answers you needed. I know how frustrating that is. I hope that the PT will help with some with the pain and there might be some relief. It can be surprising even with neural issues how it can trigger changes that affect our myofascial layer of tissue causing strain and binding, so it might help, please don't discount this.

I have worked with and been treated by DO's and many times have not been able to tell the difference between an DO and an MD, but like with both there is good and bad. Good in that they have their specialties and are well trained, (or perhaps not depending, but that can happen DO or MD), or also can be bad in that they have bedside manners worth squat and are dismissive of mental health issues attributing our symptoms to MH instead; but you can find this happening with a DO or an MD, or any medical or dental health professional. It is SO, SO annoying but sometimes it just takes a little more hunting to find the right fit of the doc for us. It sounds like it would be worth it for peace of mind and to get real answers to get a another opinion with someone you would trust with the specialty you need.

However, meanwhile, please do not discount the therapy until trying it in case it might actually help. It might ease some additional symptoms being caused by the primary pain. It is amazing how our bodies get tweaked to try to adjust to the pain and causes other tissues, especially myofascial tissue, to get out of whack pretty fast.

No matter what you decide, I do hope you find some relief soon and some help. You so deserve it and the best of care!!!! Big hugs, -F

[Rose76]

Thank you, Fresia. I will keep my appointment next week with PT. I believe you are right. I have read that the cervical problem can trigger muscle spasms. He may well have identified something appropriately. If it helps, then it helps. It won't matter then what initials were after anyone's name.

I do have a strong bias against "alternative" medicine of any kind. That's just me. I don't dispute anyone else's experience. It would be a shame to let that get in the way of me getting some help that might be useful. I appreciate your advice very much.

This practitioner did not gain my confidence. And that was when I really believed he was a traditional doctor. So I will say that he may not be a great representative of his field. The nurse who sent me to him had also recommended acupuncture. I told her I didn't believe in it. Maybe I should keep a more open mind.

I feel exhausted today. I think it is a form of being depressed.

I think it is important for me not to complain about this experience. I do have the feeling that my care has not been that great. I've been complaining about my neck for over a year. I'll try to not project a lack of faith in anyone willing to see me. I feel I've already alienated my PCP and my pdoc. They were trying to force Seroquel on me, which made me feel awful. Sometimes I just wish I could get listened to fairly, then I would listen, as well.

[Fresia]

I have a hard time with some of the alternative medicines as well even though some are even older than what is considered traditional medicine (ironic, no?), and completely understand the wariness with this! I don't see what you said as complaining but just voicing concerns, which we all have to pay attention to when our gut tells us something just doesn't seem right and getting them out is important. Your instincts are important.

It is so hard when we don't feel we are being heard and our concerns are not being addressed. I share this frustrationg and can understand why this appointment did not go as ideally as it should. I hope you find someone that will address the issues that you are having to contend with soon. Unfortunately I know many times it takes some time to find the doc that will listen and as things go undiagnosed all during this time, patience becomes the key despite the frustration. Hang in there!! All the while, depression can be a vicious cycle with the pain, fueling it and vice versa, so even more reason to take good care of you in the process. I hope you can get some rest and that there will be some help soon! Take good care meanwhile. (((((Rose76))))))

[Rose76]

Thank you, Fresia, for understanding so much.

Here is another thing that struck me. While I as in the exam room, waiting for the O.D., I thought to myself how surprisingly grungy the place looked. This is part of a great big state university health center. They are always doing new construction and renovating. As I sat in the room, I noticed that the floor wasn't shiny. It wasn't so old that it couldn't be made to shine. The exam table was old and a bit delapidated, too. When the medical assistant came in to get my vital signs, she put a pulse oxymeter on my finger. Everyone used to use those. But in other parts of the hospital, they have gone back to taking pulse the old fashioned way. I suspect that may be due to those close-pin-like finger dealies spreading germs. Also, more can be learned from feeling the pulse . . . like irregular heart beats. So I was thinking to myself, this place is pretty neglected and seeming behind the times.

I thought that was odd, since I would think that "Neurosurgery" centers would be on the cutting edge of everything. That was before I figured out what kind of a place this really was. Even the check in area was dilapidated. No art work . . . old furniture . . . greying paint. Elsewhere, the hospital complex is supermodern. Even the psych facility is more up to date.

One of the reasons that alternative medicine is getting a foothold in orthodox settings is because it tends to be cheaper. This place I was at is like the "step child" of the medical center. At least that's what it looks like. It says "Neurosurgery Clinic" outside above the door. But I suspect it is mostly about pain control. I think medicine tends to shunt people with chronic pain issues toward whatever seems like the cheapest way to handle it. I could be all wrong. I just am trying to connect the dots.

I have been kind of in a daze, since yesterday. I don't want the TV on, or the radio. I'm not reading. I haven't eaten. I feel like I'm just floating in suspended animation. I'm not even crying like when I get real depressed. It's like I'm just numb.

[liveforfish]

Get a 2nd opinion. Your insurance will cover it. When I woke up and couldn't move my neck I saw a neuro surgeon with the personality of Dr. House. (A TV MD)

I was told I needed surgery to correct 3 herniated disks in my neck.

I got 2 more MD opinions and the 3rd MD told me the first doctor I saw was one of the best surgeons in the field.

Anyway, the point of my story is seek another opinion, especially if your not comfortable or get a bad vibe.

When people buy a new washer or heater, they get several opinions 1st. Why not the same with our bodies?

Tingling or numbness indicates nerve damage or a pinched nerve. That's basic medicine.

[Rose76]

Thank you, liveforfish. Unfortunately, I don't have insurance. But your recommendation is a good one, and I can possibly be seen by other practitioners. I am covered by a county program at a state run hospital complex.

I appreciate hearing your story. I'm glad you had access to a really good neurosurgeon. With surgeons, bedside manner is really not of primary importance.

I did get a bad vibe, and I'm going to see what options I have. In a year, of so, I will be elegible for medicare. Then I can access the healthcare system that I would rather go to.

Good point about the nerve. His only remark was, "I don't know what's causing that." Like you say, it's got to be pressure or damage affecting a nerve. Right now, it's not distressing, but I wonder what it could develop into.

I live in a poor state. I don't think any doctor who is the best in any field lives here. I hope you got those herniated discs fixed and that you've resumed normal activity. My MRI and x-rays have been read as showing only mild degenerative damage. Trouble is that fear of setting off pain has me avoiding a lot of activity. Since I stopped doing all kinds of stuff, I don't have bad pain. It's just not a good way to live.

[liveforfish]

That stinks. I lived without insurance for years. I was on Cobra, insurance from the company I used to work for. I had 2 discs fused. I'm back to most normal activity. I can't look up. But my hands are functional again and I do work a full time job. I was out of work for over a year after surgery.

I have a herniated disk in my back too that I have to be careful about.

Basically know your limitations and don't over do it.

Unfortunately without good insurance, the care isn't the same. I've seen this with my kids over the years. State insurance they got the minimum services, good insurance equals better care. It sucks!!

Hopefully you can tough it out until the Medicare kicks in.

[Rose76]

I have been to my first PT session. The p. therapist is a good person. It was uplifting just to be around her. I've always felt that is one of the toughest jobs in healthcare.

She had my MRI up on the screen for me to look at with her. I was reassured by the things that look good that she pointed out. Also, she seemed to really understand the things that are not so good - mainly arthritis and some loss of disc space. Also, a smaller foramen on the left.

My doctor told me to take Naproxen daily. I did not even mention the Vicodin. At least, I feel I have someone knowledgeable to answer my questions - the P. therapist. The doctors just don't want to take the time.

[SeekingZen]

Hi Rose76,

I hope you are feeling better...how is PT going? What other treatments have you done so far? I have similar issues (cervical myofascial pain) and I was also told that it has to do with muscle, rather than bone spurs or disc degeneration. Please keep us posted.

[Rose76]

The pain is in the muscle, but the bone spurs seem to be what trigger the muscle spasms. At least that's what I've learned from my on-line research. (And the bone spurs are caused by the disc degeneration.)

Ice helps, but I don't feel much like using it when the weather is cold. Last night, I did use one of those blue lunch bag cooling packs. It does help. I've come to believe that ice/cold is great for pain.

The physical therapist suggested "warm packs." Haven't tried that yet. She gave me exercises to do. Also, she helped me understand better about maintaining better posture.

I'm interested in anything that anyone else has found helpful. It seems to just get worse from month to month. I am depressed about it.

Walking actually makes my neck feel best, as it seems to center the weight of my head over my torso best. But arthritis in my right foot limits my walking. I feel so stymied from doing what I used to do. It has me awful down. Two years ago, I felt fine. I just hate not ever really feeling good.