OT - saw back specialist today

He was really happy with the results of the nerve block procedure two weeks ago and recommends going forward with the radiofrequency neurotomy, which is where they basically destroy the ends of the specific nerves which are transmitting the pain signals.  After that, I have to do rather intensive physical therapy (which I am not looking forward to but am willing to do) and he expects very good results.  Everything he said  makes sense to me, so someone is supposed to call me in a day or two to schedule the procedure.  I'm not really looking forward to it.  The nerve block was rather painful and I am imagining this will be worse, although of course I don't know that for sure.

After my appointment, on my drive home, I called my partner to tell him what was going on.  I pointed out that he would need to drive me for the procedure, it's not something you can drive yourself  home from.  He says, "Well, try to schedule it on a Monday since that is my day off."  Now, I have explained to him more than once (the last time was just a few weeks ago when I was scheduling the nerve block) that you usually don't get a whole lot of choice about what day you want an appointment for a procedure like this.  It's not like making a dentist appointment when your dentist is probably in the office seeing patients five days a week. 

A procedure like this has to be done in a hospital.  The doctor is not at that  hospital five days a week.  He is in his office a good bit of the time, which is at least several miles away from the hospital, and many specialists work out of more than one office and/or more than one hospital.  So it's usually a matter of the doc doing procedures at this hospital one or two days a week and that's it.  You take one of those days or you don't get it done.  And let me point out that today was Monday and I saw him in his office so I'm going to guess that that means he is not at the hospital several miles away performing procedures on Mondays.  Unless he can teleport back to his office or something.  Which would be cool but sounds unlikely.

I don't know what this means, but at this point I don't even feel guilty about him having to take the day off work.  There is no one else that can take me.  No one.  If he wouldn't or absolutely couldn't do it, I don't know what I would do.  Try to hire a private duty nurse or something?  Not through an agency because they usually aren't allowed to transport patients but just someone I would pay for the day.  That's the only other option I can come up with and I'm not doing that unless it was absolutely necessary and it's not.  My partner isn't going to lose his job or anything taking a day off and it would probably cost me more than what he makes in a day to hire someone to do it, so the loss of his wages for the day is not a big deal to me, either.

So I explained one more time how I don't really get to choose the day and just said "I have to have it done."  It's not optional.  I can't continue to be in this much pain all the time and unable to do so many things for myself.  So I don't feel guilty about it, but I am annoyed.

Sorry to hear there's so much trouble for a ride. If I lived close by I would take you.

 Ugh, what a pain! Well, at least he isn't saying outright no, just being a PITA about something you've already addressed with him. So alternatives... is there a patient liason in the dr's office? Perhaps someone in the office knows something about medic transport (like for free or low-cost for those on medicaid/care) or if they could hook you up with another patient who lives nearby who'd be willing to take you? Just some suggestions....

I don't have Medicaid and even if there was some sort of transport like that for Medicare patients, I doubt it would take me that far.  It's about a 90 minute drive to the hospital where I will have the procedure.  I don't know if there is a patient liason in the doctor's office or not, but he's at the Cleveland Clinic so I would imagine there's some sort of social worker or something like that somewhere around there that I could probably track down and talk to if I wanted to.  But I don't really want to.  I just want him to shut up and take the day off and drive me.  He'll do the driving part.  I"m not sure about the shutting up part.

And here's the thing.  Or one thing, anyway.  When he had to take the day off to take me for the nerve block (which was the first time in quite a while he's had to take off work for me for anything), he was happy to have the day off.  We decided to drive up to Cleveland the night before and stay overnight in a hotel because we didn't want to have to get up at the crack of dawn to get there since I had to be there early.  He got to watch Law and Order on  TV, which he likes, and we ate at Friendly's which was right by the hotel and he got some sort of peanut butter cup ice cream thing that he liked a lot.  OK, saying that, I guess that doesn't sound like that much fun but I guess we don't have much excitement in our lives.  He had fun.  Maybe not sitting in the hospital waiting room for a couple hours, but he read a book.  He enjoyed it more than he would have enjoyed going to work.

 Yeah, he just needs to STFU and do it because he loves you!

Like I said, he will do it.  I"m just not sure if he'll shut u*****t.  I guess love only takes you so far, huh? 

Wish I had known he was sitting around that long. I would have told you how to go see the moving tree projected on the wall beyond the grand piano. Real tourist attraction. Right around the corner from the elevators where all the kitten and puppy photos are on the way to the bariatric floor.

Here's how it works. World Class Care is world renowned for picking the worst date for you. If it doesn't work, ask what other days they have. Ask if it can be done at one of the outlying family centers or hospitals. The scheduler might not know, but the doctor's medical secretary will.

On that ice cream thing, check cleveland.com for the ice cream parlor contest the newspaper is now running. There was a big article in the Friday magazine section a week or so ago about the areas favorites. You will be within minutes of a few places that make their own.

I want the soonest date available, really.  Because I am in a lot of pain.  If I could schedule it on a Monday without delaying it very  much, I would.  But I really just want it done as soon as possible.  Did I mention I am in a lot of pain?

I'll look up the ice cream contest.  I love ice cream.  I wish more places had no sugar added ice cream.  And in good flavors.  Why do they assume people that don't want sugar just want vanilla?

I'm glad you are going to get this done Kelly. I know it will help!

Tomorrow I see my spine specialist, and I'm going to have a conversation with her about the procedure. Find out if they REALLY expected my neck to NOT hurt after 26 or so injections, and if the turn-the-head-pain went away, why wasn't that the result we wanted?

Ah well... one can hope it'll all work out.

Good luck. Let us know when it's scheduled. You might remind your partner that some docs see patients on Monday, WEdnesday, and Friday,  and do procedures on Tuesday and  Thursday. If Monday isn't one of his days, it isn't. You can't change that. And even if it is, it might be that he's booked solid for the next ten Mondays, but has an opening next Tuesday.

With a bit of perspective, he'll mellow.

Oh, I've reminded him.  Multiple times.

My guess about your situation is that they wanted more than just the turn-the-head-pain to go away.  Or was that the only desired result?

My doc told me today that in his experience, and according to at least some research, people that experience at least 80% pain relief after the medial branch block get significant relief with the radiofrequency neurotomy.  Now, it's kind of  hard to estimate by what percentage you've improved, but I guess if you rated your pain on a scale of one to ten as a ten before the procedure and as a two afterward, that would be an 80% improvement.  He said some docs will go ahead with the neurotomy with just a 50% improvement but that his experience is that it doesn't have the long lasting results that it has if you had 80% improvement.

I would say for the first several days after the nerve block, I was at least 80% better.  Probably closer to 90 or 95% better.  Didn't last more than a few days but he said it often only lasts about 48 hours and how long the nerve block helps doesn't matter, it's just how much it helps in the beginning.

He also said that there is some debate about whether or not the nerve endings regenerate after the neurotomy.  He said what some researchers think is that they do not regenerate but that in some cases new nerves grow, which may then transmit the pain signals.  He said his experience is that if there is some sort of malformation at the joint, that's when the new nerves seem to grow or at least the pain returns.  He said that when there is no significant malformation, like in my case (there's a herniated disk but the bones look OK and the disk is not that bad), that if you follow the procedure with intensive physical therapy, people often get very long lasting relief, maybe permanent relief.  I'm very excited about that.