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Author Topic: magic mri (insert dripping sarcasm)  (Read 3783 times)

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Offline amoler

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magic mri (insert dripping sarcasm)
« on: August 02, 2011, 03:17:00 AM »
I fell down the stairs not quite two weeks ago. The pain in my knee has been bad and in a whole new place for me. (I've never had back of the knee pain before) I was finally sent for an mri on Sat and didn't expect to hear anything back until mid week. Lo and behold I get a phone call at 9am this morning (Monday) from the Dr office saying nothing is wrong. Which mystified me. So I went a got a copy of the report myself.

After having 30% + of my medial menicus surgically removed 20 years ago, and my medial meniscus is now magically declared "Intact".  ??? ??? ???

I don't think the radiologist even opened the image file. The new report is almost word for word exactly the same as the one from last year. Either that or he read the wrong patient file. Menisci (?) do not magically become perfect after 33+ years of damage.

I tried to contact the dr office without success today. I can't figure out if the guy is that pathetically incomptetent or if this is an insurance scam where they don't read the images, they just generate reports for billing.

I have stared at the new mri images for hours. I see what looks like 2 mild/moderate meniscus tears and a partial ligament tear. I'm a biochemist, I'm not exactly clueless.
'77- Rt knee menicus tear
'90 -2nd menscus tear
'91 -failed arthroscopy/partial menisectomy
patella dislocation 10/ 2010
Dx = grade 4 chondromalacia + synovitis + Meniscus tear + lax strained medial ligaments
Fall down the stairs 7/20/11 - mcl sprain + 2 meniscus tears

Offline aingeal

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Re: magic mri (insert dripping sarcasm)
« Reply #1 on: August 02, 2011, 03:23:55 AM »
 ;) I certainly can understand your statement about incompetence and/or "for the money" statements.  My GP just referred me to a Orthopaedist AND, I have to wait up to 10 days to get the referral through the insurance for approval.  THEN, have to wait for a letter from the doctor's office telling me that I have been approved...THEN, I have to make an appoinment and heaven knows just how long it will be before I can get an appointment after that!  See Crisis room post by Aingeal...

Good Luck!
« Last Edit: August 02, 2011, 03:27:05 AM by aingeal »

Offline amoler

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Re: magic mri (insert dripping sarcasm)
« Reply #2 on: August 03, 2011, 06:46:24 PM »
I am still getting non-stop "we'll get back to you eventually". I tried a different ortho office and got what essentially amounts to  - go away, you're too old to be interesting and somebody or other thinks you have arthritis -( gee really! like I didn't know that) The implication being that yet again NOBODY read the actual MRI and they only read the fake report. I am furious. >:( >:( >:(
'77- Rt knee menicus tear
'90 -2nd menscus tear
'91 -failed arthroscopy/partial menisectomy
patella dislocation 10/ 2010
Dx = grade 4 chondromalacia + synovitis + Meniscus tear + lax strained medial ligaments
Fall down the stairs 7/20/11 - mcl sprain + 2 meniscus tears

Offline subwayknees

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Re: magic mri (insert dripping sarcasm)
« Reply #3 on: August 04, 2011, 03:32:01 PM »
I hate to say it, but it sounds like it is time to get serious.  Several times during pre and post ops for the seven knee surgeries I have had, plus two rotator cuffs, I have felt as though radiology was not up to par.  Be it known that many hospitals send their films electronically to India and Russia to be read,  it is much cheaper that way.  You have NO idea who is reaing the film. Thererfore I would call Hospital Administration and demand that the Chief of Radiology for THAT hospital review the actual film, and the last one in file.  You can give them a deadline and the circumstances,  you may even want to drop the word "my attorney" into the conversation.  This usually gets a response in 24 hours and you get what you need, proper information.  It is a shame it has come to this, but with so many hospitals and large group practices transmitting mri's, cat scans etc to third world countries where people with less background than many RN's have read them under "the supervision" of a radiologist they usually never see, you have no idea what you are getting back.  It is a shame more people do not know about this push for off shore consults by hospitals and large medical groups.  You get what you pay for and I would rather have a Western (European or American, Canadian) radiologist read my films that someone in a third world country who is usually no where as near well trained.  Welcome to public health in the USA.

Offline amoler

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Re: magic mri (insert dripping sarcasm)
« Reply #4 on: August 04, 2011, 06:36:26 PM »
Subway-- I'm receiving claims that somebody" in house"looked at the images and they swear up and down that there's nothing wrong. I tried to talk to a lawyer about it. They're not interested. There's not a single dr that will see me. I even received a phone call from the pain management secretary at the GP's office saying they may cancel the appt I already made because that guy isn't interested in me either. I haven't sued anybody - all I've done is tell about 6 people I think they're wrong, very wrong. I have spent most of the past day in tears. It hurts so bad and noone even believes me.
'77- Rt knee menicus tear
'90 -2nd menscus tear
'91 -failed arthroscopy/partial menisectomy
patella dislocation 10/ 2010
Dx = grade 4 chondromalacia + synovitis + Meniscus tear + lax strained medial ligaments
Fall down the stairs 7/20/11 - mcl sprain + 2 meniscus tears

Offline subwayknees

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Re: magic mri (insert dripping sarcasm)
« Reply #5 on: August 04, 2011, 08:33:28 PM »
I understand why no attorney would be interested.  They only want to take claims they know are a sure win or settlement.  In your case it is way to early to deal with an attorney,  I suggested dropping the idea to get action from the hospital.
If I were you and it was geographically possible I would go to a different hospital and show up at their emergency room.  If the pain is that bad, it is your body telling you something is not right.

I would call the pain doctors back and speak to them frankly, saying you really need help.  I know for a fact that pain management doctors are very concerned about seeing patients with no specific cause for their pain.  It is unfortunate but they label those patients as "drug seeking" simply going to pain doctors to get opiates, In a way you can't blame them as the feds and many local drug task forces watch pain doctors very closly to be sure they are just not handing out scrips for drugs.  In the past many have and it gives the good ones a bad name.
If your local General Family doctor is unwilling to work with you it may be time to start fresh, but with the pain so bad you sound like you need immediate attention.  I know there are issues with insurance, etc. but if you show up at an emergency room at another hospital and tell then what has happened and that you need some type of help it may be your best bet.  It sounds like you have a group that for whatever reason just does not believe you.
I have worked in the past in hospitals befoe I became a music teacher, and I can tell you that hospitals and doctors are very bad about  perscribing pain medicaion especially through the emergency rooms.  In fact I have a friend whose son is in Medical School and when his advisor learned that he wanted to go into a pain mamagement residency the advisor said "don't do it"  The Government monitors these doctors closly and sends agents on a regular basis to review charts etc and if they perscribe to many opiates they could even be brought up on charges of criminal activity.  Very few doctors are wiling to jepodize their licences by giving pain meds through the er unless it is obvious they are needed, like a broken arm, major cuts with many sutures etc. but when you go in and they can't find anything wrong and you say you are in pain they just write you off as a drug seeking patient,  that may be what you are dealing with, that is why it is so important to communicate fully in a firm way with the doctors, and if you can't get to them at least try speaking with thier nurse, do not leave it with a clertk or office secretary.
Maybe you could try and get a call into the nurse supervisor at the hospital that did the mri at least that way you are speaking with a medical professional not just a clerical person, and if you have to, simply go to a different hospital emergency room, be totally honest but firm and tell them they MUSt do something to help you because the pain is so bad.
I am sorry to give you bad news but as someone who has been in pain management for many years and worked in hospitals on patient care units I know the issues involved in dealing with pain.  In fact I just posted erlier about my concerns about post op pain management as an opiate dependent patient.
Good luck, and be firm you are in the end your best advocate

Offline amoler

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Re: magic mri (insert dripping sarcasm)
« Reply #6 on: August 05, 2011, 02:16:25 AM »
The MRI was not done at a hospital. It was done at a private company. I demanded repeatedly for an outside source to read the scan and been told "One of out people looked at it again." What an absolutely amazing CYA manuever.

 No offense but have you ever gone to an ER for pain? I have migraines. They laughed in my face and told me to get the hell out of there (literally) I had already sobbed in their ER waiting room for 5 hrs at that point. I went with severe bronchitis last spring, coughing so bad I nearly passed out and they shrugged and offered me medication that makes me shake like a Chihuahua on speed. (Previous experience) When I asked for something else, they refused and then said they wouldn't give me anything at all, not even non-narcotic cough medicine.

I would have to have broken bones protruding through my skin or be bleeding from the eyeballs for the ER to even consider treating me. I have no options at all.
'77- Rt knee menicus tear
'90 -2nd menscus tear
'91 -failed arthroscopy/partial menisectomy
patella dislocation 10/ 2010
Dx = grade 4 chondromalacia + synovitis + Meniscus tear + lax strained medial ligaments
Fall down the stairs 7/20/11 - mcl sprain + 2 meniscus tears

Offline subwayknees

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Re: magic mri (insert dripping sarcasm)
« Reply #7 on: August 05, 2011, 02:53:49 PM »
i ACTUALLY SPOKE WITH MY DAUGHTER WHO IS A NURSE AT A LARGE TEACHING HOSPITAL,  SHE AGREED THAT ESPECIALL AT AN IMAGING CENTER THERE IS A BETTER THAN 50/509 CHANCE IT WAS AN OFFSHORE READ.  sHE SUGGESTED YOU ASK FOIR A CD DISK OF THE MRI AND TAKE IT TO ANOTHER DOCTOR.  mANY EXCELLENT ORTHOPEDICS WILL NOT WANT JUST THE WRITTEN REPORT BUT ACTUALLY WANT TO SEE THE MRI DIRECTLY.  You have a legal right to the disk.

As far as an er, I was only trying to suggest how you could at least see another doctor without waiting weeks for an appointment.  You are correct.  ER's do not do a great deal unless you are at deaths door, but I thought a new hospital may refer you to a different orthopodic surgeon.  I too have spent many hours in er waiting rooms only to be told to see my private doctor.  Sorry that is allk I could think of.

But I would tell the company that did the mri you will be ther to pick up the disk, that is how they send them and store them, once you have the disk you are in more control and can bring it to other orthopedisis or pain docs.  Don't let them put you off as at least in the US that disk is your right to get.  If you are over the pond I am not so sure, but I assume you have a right to it also.
 I have also learned that sometimes we have major pain and the doctors no matter how good they are do not understand the cause.  I have a friend who suffers major back pain and is in a wheelchair and the spine specialists have no idea what the cause is.  The actually implanted a pain pump in him for relief, he is feeling a little better but still has very bad days and no one knows the cause.
Sorry if you feel I led you down the wrong path, but sometimes you have to use and er as a portal to a new set of physicians affiliated with a different grop or hosp[ital, in your case though I would take the disk once you have it to another physician, an orthopedist first to get another opinion    and do not take no for an answer.
Sorry for the caps, hit the wrong button before my morning coffee.
Please keep us posted and if I can think of anything else I will follow up I am actually on my way to a doctor appointment right now.
How is your pain level today?

Offline amoler

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Re: magic mri (insert dripping sarcasm)
« Reply #8 on: August 06, 2011, 04:14:34 AM »
I got my accupuncturist to have a quick look at the mri today. He said it's obviously not his specialty but he's seen quite a few , and thinks my hamstring has a tear, and that part of my menuscus is practically disintegrated and all the loose pieces are probably grinding against my osteophytes ( aka bone spurs from arthritis) He even said he wondred if this was -an only gets fixed by surgery deal. :'( And this is a guy who I adore because he normally has such a dim view of surgical solutions.

He recommended I spend the next couple days  minimal/ no weight bearing on crutches and see if it lessens my pain any. Other than that I'm still in absolute limbo until somebody condesends to give me an appt.
'77- Rt knee menicus tear
'90 -2nd menscus tear
'91 -failed arthroscopy/partial menisectomy
patella dislocation 10/ 2010
Dx = grade 4 chondromalacia + synovitis + Meniscus tear + lax strained medial ligaments
Fall down the stairs 7/20/11 - mcl sprain + 2 meniscus tears

Offline subwayknees

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Re: magic mri (insert dripping sarcasm)
« Reply #9 on: August 06, 2011, 04:18:10 PM »
amoler,  I am glad you got the mri's films that is a start.  Just keep pressing for an appoitment and don't take no for an answer.
I do have a question for you, please.
I have been taking large amounts of morphine for many years 400 to 500 mg daily and most of the time it does not good.

I was desperate and went to see a Dr. of Chinese Medicine for acupuncture.  I went only twice.  During the first visit as soon as he put the needles in I did get some relief, then he had me walk as much as I could with the needles inserted for about five minutes, then another 30 minutes in a bed.  I got relief for a day or two then the pain was right back.  Also the pain from some of the needles, especially the ones in my finger tips was worse than the knee pain which was killing me.  I actually asked him to take one needle out.

More pain from some of the needles, especially in my hands.  I am a clasical musician and my fingers are the key to my income ,Violin and Violoncello. I mentioned this to him and he said I would have no pain after the needles were taken out of my fingers.  Well I had a performance that night and had to cancel my fingers were so sore.

I never went back.  From what I have read you are not supposed to feel the needles,  This man said he uses a different school of acupuncture than most, he also tried to sacm me,  When I called I spoke to him directly and he said he charged 80 for a session.  When he was finished with the session he asked me for $150.  When I told him I recalled him saying it was $80.  he said that amount was for the session and the other 70$ for the analysis of my problem. He never mentioned the "analysis fee before the appointment.  He spent less than five minutes asking me questions before he started placing needles.' I took my x-rays, mri results and medication records with me to the appointment and he never enen looked at them. Well I told him all I had was $80.00 and would pay the difference the next visit.  I had a performance that night and my fingers hurt so much I could not play properly and had to cancel at the last minute leaving the orchestra administrator to seek a last minute cover.  This was not good at all.
Have you had better results from acupuncture for knee issues, I know from friends they get results for back pain.  I was thinking of trying someone else but after this experience I have stayed away. 

Offline amoler

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Re: magic mri (insert dripping sarcasm)
« Reply #10 on: August 06, 2011, 05:16:26 PM »
Love, love, love my accupuncture guy. (he does chiropractic work too, but that's not what I go to him for) I almost never even feel where the needles are put in, and I've had them in my legs, my face and about 40 other body parts. Every once in a blue moon, I'll get a little pinch sensation from one. I think he put about 15-18 in the back of my knee yesterday. I think I felt one of those. For me accupuncture is not a one stop sort of thing, when it works for me it takes at least a half dozen visits to really start making a dent. But I've been going to this guy for nearly 9 years. Sometimes I only see him every 6-8 weeks for what kind of amounts to routine maintainance. If he had the ability to write rx's and order anything other than x-rays and simple blood tests - I'd go to him for darn near everything.

I will say the pain level didn't have me wanting to scream at the ceiling last night. It's still very defintely there but I mostly avoided that thing where it hurts so bad you're not sure if you're gonna puke.

I agree, sounds like the guy you saw was something of a scam. Even the alternative people I've tried in past few years were way more professional than that. Flat fee, you get service rendered. I've tried massage, a little yoga, meditation group, and even got desperate enough to try an "energy field" lady. ::) Yeah, I know that sounds way flaky. She was really nice, but it didn't help with the pain.
'77- Rt knee menicus tear
'90 -2nd menscus tear
'91 -failed arthroscopy/partial menisectomy
patella dislocation 10/ 2010
Dx = grade 4 chondromalacia + synovitis + Meniscus tear + lax strained medial ligaments
Fall down the stairs 7/20/11 - mcl sprain + 2 meniscus tears

Offline subwayknees

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Re: magic mri (insert dripping sarcasm)
« Reply #11 on: August 06, 2011, 06:11:47 PM »
Thank you.  That is interesting, the guy I saw put needles in my hands my fingers and then my feet but never near the knee.  Once he insterted them  he made me walk, saying I would be spreading the energy through the body.  Try walking in circles with a bunch of needles sticking out of hour hands,  I felt like something out of a Halloween movie  I havt to admit something did happen as the pain in the knee did get a lot better, but it was a trade off. But the next day I was right back with bad pain, so i only got a few hours of relief.   Rally I can take pain, I am a Viernam vet and know what getting shot feels like, but those needles in my hands and fingers really felt bad.  I figured I would be ok with a person from China who studied there, but I do know there are some chiropractors in my area that also do acupuncture.  While I am waiting to see if I will whimp out of the new revision date I may call one to see if I can get any relief.  This time I will be sure to ask about fees ahead of time.  It was really a scam, because I recall in speaking with him when I made the appointment asking specifically what his fee was, because I knew it would not be covered by my insurance and all he mentioned was $80 per session, never the other $70 fee.  But that is history and I frankly never gave him the additional $70.00.  I am glad you are feeling better,  I had two fairly decent days where I have not needed extra morphine, but that is after a week from hell when I could not leave my room for six days the pain was so bad.  It seems this knee has a mind of its own.

Offline amoler

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Re: magic mri (insert dripping sarcasm)
« Reply #12 on: August 08, 2011, 11:10:58 PM »
I have been shot down yet again. The pain management guy at the PCP office refuses to even see me, because I went to a different pain place to get the mri done and "and my pain is being managed"  How on earth does  one tube of Voltaren gel qualify as pain management?? ??? And it doesn't even help. I'm back to wanting to sit and cry because nobody gives a hoot AT ALL. Even, just even, if it is "just arthritis" how does that qualify me for zero treatment.  I am being told by every single office to suck it up and live with the pain- we can't even be bothered to actually see you.   :'(
'77- Rt knee menicus tear
'90 -2nd menscus tear
'91 -failed arthroscopy/partial menisectomy
patella dislocation 10/ 2010
Dx = grade 4 chondromalacia + synovitis + Meniscus tear + lax strained medial ligaments
Fall down the stairs 7/20/11 - mcl sprain + 2 meniscus tears

Offline subwayknees

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Re: magic mri (insert dripping sarcasm)
« Reply #13 on: August 08, 2011, 11:58:04 PM »
amoler, I have spent over 5 years in pain management and I think I know my way around these docs. I do not know but assume you live in the United States as this site gets a lot of Posts from England also.  No pain doctor in the U>S. will see you if you are under the care of anohter doctor for pain.  Legally they must have a letter of discharge saying the other physician is no longer treating you for pain or have you sign a contract at the first visit saying you will not seek pain medication from anyone else, even a dentist..  That is due to the amount of doctor shopping where pain patients with NO pain would go from doctor to doctor to get scripts for morphine onycontin etc and either sell them on the stree or use them illegally. It is those junkies that mad it so difficult for someone in pain.

As soon as you mention to a doctor that yopu are seeing someone for pain they back off untiul they get a written discharge letter with past records from you last doctor.
In my area of the country Wash. D.C. and even in Myrtle Beach where I have a vacation home the states monitor all scripts for opiates on a central system and will come after the doc and patient if they show too many scripts with no urine tests oir if the patient shows up geting same meds more than once a month especially from different docs.

All I can suggest is that you speak with your Family physician about referring you to a pain management specialist, with a written referral stating he/she is no longer treating you for chronic or acute pain and gives the go for the new doc to see you.  My daughters mother in law has severe neck and back pain and fibromyalgia and in constant pain and even with that the pain docs do not even want to give her 5mg hydrocodine three times a day and that is like baby aspirin.  The only reason that I get over 500mg daily of morphine plus additional methadone for breakthru is that I have documented 8 plus surgeries on my knee, and documente  mri's showing a loose prosthesis.  Also even though I have never run out early or overused etc. I am still after five years screened at randon during visits to my doc.  Once I came back from New York City and had my favorite New York Poppy seed bagles and brought a dozen home with me and tested positive for heroin.  Luckly my doc knew I was going to N.Y. and understood that poppy seeds can show positive in some drug screen tests. I have no idea how a newer doc would have done with that.
Back to you, the key is to make as many phone calls as you can to pain management practices in your area and ask what they require for a first consult visit.  I know in my area there are still some pain management practices even very large ones that will accept new patients without a consult so long as you certify in an actual written pain management contract that you are not seeing anyone else for pain medication.  I know several people who actually have to drivve 90 miles to get to a pain management practice that will see them for undiagnosed pain but it worth it.  The other option and this maybe I sould not mention but in states that have legalized medicl marajuana doctors who do perscribe do tend to advertise in the college type papers.  In no way am I giving legal or medical advise but I do know that even Washington DC has physicians that have just begun to perscribe that, however you cannot take it out of D.C. and these is always the question regarding the different state and federal laws although i do know some chronic pain patients who do get scrips easier than they do for opiates, but I am in no way dpoing anything than posing it as an option and suggest if it is legally available you check the laws very carefully in your state.
All said and done I see no reason why you should suffer,  I know what off the chart pain is like, even with my high level of opiate use I still have pain frequently off the chart and I know I cannot use more than I am alotted or I will run out early.   I would continue to research pain management practices on the internet and keep calling and you may find some that will accept you on just a contract not a formal referra.

Keep me posted, and I will see if I can come up with any other ideas as I know what chronic pain is like

Offline subwayknees

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Re: magic mri (insert dripping sarcasm)
« Reply #14 on: August 09, 2011, 12:15:07 AM »
amoler, actually there is an option I recall a friend of mine used who was unable to get needed pain meds locally, she lived in South Dakota and had a hard time finding a pain doc.
There is a web site (painmedsonly.com)  I have never used them and know nothing about them except they claim to have U.S. licenced doctors available here in the U.S. who will communicate with you via email and perscribe needed pain medication.  The specifically list all the states they are licenced in.  Unlike medical marajuana where there is a question these are state licenced physicians that perscribe only pain drugs but through an online practice.  I think,but you may check, that they write the script and then you take it locally to be filled.  I know nothing regarding cost or insurance etc.  But in a real pinch were someone is really off the wall in pain since they clain to be 100% legal I would at least look them up.

I do know that some practices in certain specialties that are now treating patients online so it may very well be just a new practice that is totally legit    You may want to give it a click of the mouse and decide for yourself  as I said I have no personal information on them other than they did help my friend and she still uses them