Worried....New MRI..missed Dr. call on Friday

[ajspine]

and increasing pain. So sorry I haven't been on the board to help support others but my headaches have been back and most of time has been spent with Grad school. I just had another MRI on Thursday(to look at the cervical ADR they put in 8 months ago) and got a copy of the disc before I left, but it was just read yesterday. I missed my Dr. call and her message got cut off so I all that was said was: "Hi AJ, I don't have anything extremely urgent but." Then the message cut off, and of course the office was closed by the time I called back. My Pain and numbness have been increasing and we finally have some meds that work and I was hoping to be back on track. I have attached one of the images(Sorry its so big, I can't make it smaller) and it does not look right to me, but I am hoping that they are supposed to look like this following an ADR because the MRI could look different. Any input would be greatly appreciated as I am scared and won't be able to talk with the Dr. until 8 am on Monday. Thank you so much.
AJ

[mmglobal]

With all the "I'm not a doctor" qualifiers... this is metal artifact... MRI is Magnetic Resonance Imaging and magnetic metals distort the image. My MRI's look just like yours at the levels with metal.

Even with endoscopic discectomies where no metal is implanted, microscopic metal debris left by the surgical tools can substantiall distort the images.

Take a breath.. relax... it is unlikely that what you are seeing is actually what it looks like.

Mark

[ajspine]

Mark,
Thank you so much, I was worried. And I am still concerned because my Drs have never called right after an MRI. They probably just want me to go back to NS to address the other problem discs. Have a great weekend!
AJ

[mmglobal]

I had the same thing happen with me last year. A thoracic MRI showed a huge spot in my spinal canal where nothing had over ever been seen before. OMG... a tumor? OMG!!!

It turns out that CSF (cerebrospinal fluid) is pulsatile... you can feel the heartbeat in the thecal sac. That pulsing comes from the movement of spinal fluid. If the timing if an MRI slice is perfect, it can image a 'bubble' of CSF.

I spoke to the radiologist and he explained it, saying that this is common. I thought it was weird because I've looked at thousands of MRI's in the last 15 years and hadn't seen this. Amazingly, the very next MRI that a client sent me showed the same thing.

Interesting stuff!

Take care... you have a great weekend too.

Mark

[ajspine]

Thanks Mark. I need to stop worrying so much but the VA has made mistakes with me before. "Once bitten, twice shy", Don't know if that is right, lol

[Maria]

looking at your MRI and not knowing what I'm looking at other than the ADR I'd have wondered if it should look like that as well and if it were a reason for concern. I hope your doctor was just going to tell you to follow up with xyz should your symptoms increase or give you warning symptoms for hitting the ER/ED. Other than that hoping that what was said is correct re "nothing extremely urgent but..." and you can relax and follow up on Monday. Good luck. The unknown is often scary esp. with some of this crazy spine stuff.

[ajspine]

Hi Maria,
Thank you so much for your input and advice. I really should post my nightmare of a story with the VA on here. The past six week since I posted have been hell. I have to basically fight for my pain meds and one VMAC treated me like a Junkie. But when I filed a congressional inquiry, they said I was lying and a drug addict. We still have the investigation open. I am so tired of being made to feel like a bad person and/or Junkie just for the medication that allows me to function without lying in bed crying. Thanks for taking a look and listening. Have a great day!
AJ

[mmglobal]

AJ, I don't want to suggest that your experience with the VA is not horrific. I do believe that the treatment of our veterans is a national disgrace that should receive receive the highest priority.

But, the experience of chronic pain patients being treated as if they are simply drug seekers is all too common in the spine patient community. It also kind of snowballs as we go to the next doctor and try to explain about the last one denying you access to meds... you never get past the first few sentences before the new doctor assumes that you are a drug seeker.

We have to give some of the providers slack as, under the best of circumstances, they will deny drugs to some who need them and will also give drugs to others who shouldn't have them. The patients who actually do have a drug problem or are getting meds only to sell them do serious harm to those of us who need them. In many, or even most cases, the providers are doing the best they can.

I've seen unbelievable cases in which patients have horrible litanies of failed surgeries, with metal all up and down their spines who are denied meds. This is a serious problem for too many of us.

Call me during the week and I'll have some suggestions for you.

Mark

[Maria]

AJ,
I remember when I worked for the VA in San Francisco in the Neurosurgical unit and the attitude of the fellows and residents on rounds towards patients they thought were "users" or "slackers." I was 27 at the time and knew nothing of chronic pain or even acute pain. I injured my spine the following year but I had left the VA system for the University system. What a rude awakening into the treatment of back pain and patients with back pain let alone a nurse with back problems.

I was never even offered pain meds until 2001. First spine surgery was '89 and second was in '92 and failed terribly. While I have too have gone thru some "attitude" not quite what many have experienced though enough.

My own attitude towards pain meds was shaped and formed by the career I was in and the attitude of the healthcare practitioners I worked with for many years (and that was that people that used pain meds on a regular basis were drug seeking most likely or poor lost f'd up losers.) I can remember clearly when I had joined another spine forum where the majority of people had multiple spine surgeries under their belts and were on pain meds. I thought I was doing so much better than them because I didn't take anything however I was off my feet all the time crying all day long and thinking some very unpleasant thoughts about being alive in that much chronic pain.

I don't know what kind of coursework most physicians have in medical school with regard to working with patients in chronic pain if any. Episodic pain is one thing but chronic/ intractable pain is quite another. Even some of the PMs I've seen may well understand the physician's side of it but the patient side of it is more of about $$$ that can be made by various treatments.

You may not want to post too much detail about yourself with regard to your situation since your case is still open right now.

I wish you the best and hope that you don't have to suffer thru anymore than you already have. I don't get where people in healthcare don't understand that labeling a patient in pain with other labels doesn't "help" patients heal or get better but then again I do understand some of the fear and attitudes in medicine though that doesn't justify what people who are legit with problems are made to suffer and go through. IMHO.

[ajspine]

Mark and Maria,
Thank you so much for your responses. I would like to say that not under any circumstances do I think that Vets should get different treatment than civilians, I feel that we should ALL get excellent care. And with your advice I will no longer post about the bad experience I have had through the System.
I will say that I understand how pressured the Providers are, I have not been in terrible chronic pain as long as you and I am not looking forward to years and years of this fight. Which is why I have started Aqua therapy and deep tissue massage. Deep breathing and a Chronic pain group therapy. I am looking for other ways to find something that works. Giving these Drs. this much control over my life has to change.
My Mom has been a RN for 37 years and MSN for 20 and she is disgusted with the way Pain is treated everywhere. She makes it very clear to me that it is not just the System that I am dealing with, but ALL of them. She says that chronic pain is barely addresses in nursing and med school and that this should change.
No one knows the answer to this problem but I do know that we should not let the Government practice medicine by threatening provider's lively hood if they are helping patients and are properly licensed to do so.
I love this site, it has been so helpful and informative for me.
Mark, I will Contact you this week, please PM me a good time that works for you. I could use just a few pointers and some advice. Thank you guys so much.
AJ

[ajspine]

Also, I have just been approved for a Civilian Pain Management clinic via fee basis. Since the VA clinics are 2.5 hours away, on way, they have given me permission to receive care at local clinic. This was excellent news.

[Maria]

AJ,
great news! I am surprised with so much PTSS that any military doctors would not get the treatment of pain as even that can spiral into part of or stem from PTSS.

As an retired RN,NP (family practice) I really dislike when I see an NP or PA with an attitude and even less like it when they have had less clinical experience than me yet are condescending. Of course I do not care for a physician with little experience treating back pain or chronic pain to give me any lip about my pain meds either yet there are times when I see a new practitioner I get "that look" and a few words of advice re my pain med.

Thankfully I can say that I've been well managed in PM with the same physician since 2004 whom I hope I am able to continue to see as my future medical work comp bennies pay for that. I travel several hours to see him and usually only go every 3-6 months if my scripts will last that long.

Currently WC pays for nothing really other than my pain medication which is one of the oldest opioid pain meds out there and dirt cheap. I have however been thru the PM hoops and have to say I'm so thankful how much ESIs helped me and an understanding ear as well and a few really good PMs or people that worked with pain patients. Makes a huge difference to have one's pain addressed correctly and adequately! Wishing you all the best on the latter and hope for your continued improvement over time!