Off to the PM Today

[Kathi49]

Hi All,

Just wanted to mention that I will be going to the PM today. I want to talk to him more in depth about the coccyx issues along with pelvic floor PT. I STILL want to know what nerves are involved here. And I really think an MRI of the sacrum and coccyx is in order. But maybe not...maybe he can tell me more just from the fluoroscopy pics. And, well, not to be graphic but the Levator Ani muscle(s) are involved. Geez, I just want to know...what goes to what? LOL The PT has done some releases of those and the Piriformis which has helped a LOT! Still amazing to me. But that darn coccyx has me concerned. Maybe with continued PT it will get better. She did mention at least two more months. Anyway, she is to have a full report for me today to take to my PM and is sending another to my Urogyn. I have to laugh sometimes because that pelvic floor is way too complicated for me to totally figure out by myself. As she said, there are other things going on with the spine...so off to the PM I go!

Anyway, for the real killer...

I heard through the grapevine that my PM is leaving to start his own practice! I sure hope the person that told me this is...maybe wrong. The group I go to has 4 locations...so I am thinking he may just be going to another location/hospital. In any case, I want to find out the real deal. If he does leave, I know it will be in the southern portion of Indy. So, I will just have to follow him even though it will be a little further for me to drive. If I can't do that, I will just have to ask who he might recommend out of the other 3 or 4 Anesthesiologists. Anyway, I was depressed when I heard this. But it all might turn out just fine. And I am sure hoping my friend might be wrong...she did say she couldn't remember EXACTLY what was told to her because it had been awhile. Oh well, I will just have find out today what is going on.

[Mark N]

Kathi, have a good visit with the PM. I hope he has answers to all your questions and that he isn't moving to far so you can follow him to the next office.

[BrokenBladder]

Kathi I also hope you have a good visit today and that if you PM is leaving that he will still remain close enough for you to see. it really stinks when a doctor we love leaves, retires, or something of that nature. Good doctors are so hard to come by.
Let me know what you find out from your PT. I can tell you that as much as I researched it I was still confused on some things!! It's was too darn complicated for sure. Even though it didn't do me any good I'm still interested in learning about it so make sure to keep me posted, via PM. it's TMI for the open board, that's for sure!!

[simby]

Hope the appointment went well.
And i hope the news about your doc's moving ends up being good news. Or at least ok news.

sims

[Mark N]

Kathi, What did you find out today? I hope you still have a PM doctor and you got some help with your shoulder.

[Kathi49]

Thanks you guys!

But, oh boy, am I tired. I will probably write more tomorrow because it was PT, then PM and then a birthday dinner with my mom.

Briefly, everything went well and I still have my PM or as he put it, "You can follow me to the ends of the earth!" :) Actually, I was half right...he is going to the hospital that I thought it was (not sure if I can name places here) and will be heading up their New Spine Center; or at least that is what his nurse said! So, I was very, very happy for him. But bummed because it is further. But I did say, "Please don't tell me you won't do injections anymore!" And, no, not that I live for them at all! It's just that I only trust him! He just laughed and said he still would but that most of it would be administrative. I also asked that IF I had to, please level with me and off the record, recommend another Anesthesiologist within the same group I am with now. And he did. I am GLAD it wasn't the one I was thinking I MIGHT have to see. Not that I dislike him personally; he just does not provide feedback at all. And getting any answers, as I was trying to do FOR my husband, was like pulling teeth!

Anyway, I think I will go to where he is going as he did say he would still be working with the same surgeons he's with now. I will just have to see how it goes. But I much, much prefer it if I can stick it out with him as my PM. It is just a matter of dealing with the darn drive and traffic. Oh, but my mom told me of a better shortcut today.

Anyway, there is so much more to tell and as Lisa said...so darned complicated. But I just want to go to bed now and put heat on my butt! LOL I think the PT gal cranked the Ultrasound machine up a notch to high. :eek: Sorry, I would write more...just exhausted...so...until tomorrow. But thanks for the concern you guys!

[curiousforever]

Go get rested up!

Glad it's gonna work out!

[Mark N]

Glad to hear you had a good visit and home doing okay but tired. Rest up and talk to you tomorrow.

[brians2000]

I just want to say good luck.

[BrokenBladder]

Rest up Jathi and then get back with us and let us know everything else that went on. Wow you had a very busy day!!

[Kathi49]

Hi All,

Okay, back...early am, but more rested. :) Plus, and I forgot to mention it, I had something in my left eye yesterday that was driving me crazy. And yet another reason to lie down and put a cold washrag on my eye. I was thinking...geez, don't tell me I am getting some kind of infection in my eye. Allergies have been kicking up a little...but the eye is better this morning.

Okay, get ready for a book and I apologize ahead of time. :)

PT - It is going very well. According to her the piriformis was much better and seems to be loosening up. I just asked her yesterday to just to do a repeat of what she had done during the previous session because I wasn't sure what my PM had in mind. I told her at times the coccyx bothers me a little and so does the lumbar/sacral area...but overall...for the lower portion...I can sit much better. She says I am responding well and I can definitely tell but that I probably need another good two months. Right now it is relaxation stuff...later...strengthening. Anyway, she said my Urogyn would have no problem extending the treatments. So, she just faxed her assessment and gave me a copy to take to my PM. Oh, and I guess the hips are better aligned too...something like that. All I know is that the left one is not hurting at all like it was. And the sciatic type of pain is going away too. And when she did the deep heat ultrasound treatment on the left cheek it felt sooo good. But I will get to that later. I didn't realize that that can go pretty deep into the muscle...so ouch...later on.

PM - This part is a trip LOL! His nurse took me in to ask the general questions she always does. And I said, "I heard Dr. ____ is leaving!" And she said, "Yep, going to ______ Hospital to head up the spine center there. He'll be the head honcho. Excellent move for him but patients are upset!" Anyway, let me rephrase something too. The more I thought on this the more I am thinking he will probably head up the pain management portion...just not positive about that.

Anyway, so he came in and asked me how the pelvic floor PT was going so I gave him the notes and explained what all she was doing. He was VERY interested in all of that and wanted to know if their was a list of therapists or if I had a list...he would like to use them too. I told him that a Dr. ____ is the one that had the list. So, I just told him he could contact the gal I see or I could ask her if she wouldn't mind sharing a list she might have. Anyway, he was just very intrigued with all of that and was glad to hear it was helping.

So, to the spine. The fluoroscopy pic is just weird. The coccyx DOES look strange and I can barely explain it. But he showed me where the break had occured and it IS old. And I asked him if it was healed a little to the left. And he laughed and said, "Even if it is, we can't put it back!" But did say there are so many ligaments it is possible that it is being pulled on. I was just trying to figure out what attached to what and he explained all of that too. Just said that it was a whole network of STUFF! LOL

Anyway, he went to my MRI report and circled where the majority of issues are...L4/L5 and S1 and told me he had RF'd those levels. Anyway, so there is facet issues and a disc bulge. I told I hurt worse when I try to sleep, lie down or stand for a long time. Walking is not an issue...it helps more. But what really, really pains me is the outside of my calves, my ankles and the last 3 toes. That is what really wakes me up a lot. And it is always the outer sides of all of that. So, he said, "That's L5/S1 my dear!"

So, then he takes me out to view my films. And showed me the disc...and he said a little stenosis is happening but not that bad...yet. And then he said that it should look more oval in shape but that level is starting to look like a triangle...thus encroaching...I guess. Anyway, he just compared it to the other levels and I could see the difference. When I asked what to do about that he said we should probably get another MRI first since the one I have is older than a year, I could have an epidural and if and when it got really bad a laminectomy. But to walk as much as I could. So, crap, I will probably get another MRI as soon as I can. But in actuality, the lumbar/sacral/coccyx pain was probably just a one or a two yesterday...not bad at all. I just told him I didn't feel the need for an injection at all...I just wanted to talk about all of this stuff to get a better understanding of it.

Oh, I did ask him about the Duragesic patch since I was a chicken to try it. I said, "Hey, I didn't try it because when I read the insert, it terrified me!" And he laughed and said, "You shouldn't have read the insert!" But he was teasing. And he said, "If you ever read the consent form for the injections, you would really be scared!" Well, true enough I guess. I just sign the darn things...guess I should read it huh? Anyway, he said, "Just try the patch and use Vicodin for break through pain if you have to." So, I may just go ahead and try it...after all it is only 12mg.

So, for the REAL conversation....

Like I said I was afraid he would recommend this other guy who is my husband's PM. Well, you know guys LOL! Sorry, no offense to the men out there but my husband just wanted the darn pain stopped and didn't know the questions to ask and probably didn't care to ask. That's why I went with him. And he has a pretty bad herniation. So, there I was saying..but what about this and what about that. And that guy looked at me like...shut the he** up! But I swear he barely provided any answers. So, that is what was annoying to me. Crap, maybe I should have left well enough alone but I was just trying to help my husband better understand the diagnosis.

So, that's why I was asking my own PM who HE would recommend. And he said Dr. _______ because out of remaining PM's, he was the most compassionate. And did add that with all of the pelvic stuff I have going on, the others would look at me like, "You are woman, you are crazy, shut up!" And I believe it! But that the other doc wouldn't do that at all. He was NOT bad mouthing the others at all...just saying if I wanted a compassionate PM, Dr. so and so would be the better choice. So, just being honest and that is what I wanted to know...who would be the better choice IF I had to make choice.

I guess overall there is just a lot going on with the spinal and pelvic stuff that I will just contend with as time goes on. First things first though...another MRI.

And, last but not least my mom's birthday dinner was great! She turned 80 and acts 18! It cracks me up! We ate outside...at a restaurant on the reservoir and it was really nice. But darn the chairs were a hard metal. So, my left bun hurt like heck! And I know it was from the treatments yesterday. It happens but will calm down in another day or two. But I couldn't get home fast enough to get in a hot tub and lie down with some heat.

And that's that for now. :)

[suede]

Kathi,
It sounds like you have a really super PM and I can sure understand your dilemma about his leaving.
It has been that way for me also, when I get a good Dr I can really trust and have a good relationship with, they leave.
Sounds like he has things under control, good luck.
Linda

[simby]

glad it went well.

hugs,
sims

[BrokenBladder]

Wow Kathi what a day you had yesterday!! Your PM sounds like a gem!! Actually so does your PT.
Sounds like you had a good time at your mom's birthday part, but those metal chairs are impossible for me to sit on!! You did good!! I would've been on the floor about 15 minutes after getting there.

Take Care,
Lisa

[Kathi49]

Thanks you guys! :)

I have always said I just love my PM! And, really, when it comes down to it it is his understanding and compassion. And it doesn't hurt that when I get those injections...he goes easy. :) But, I was so bummed out when my friend had said a month ago he was leaving. I just didn't say anything here at that time because I didn't have the details and I wanted to talk to him first. Oh, all of his patients are supposed to be getting letters. So, maybe that letter will FULLY explain all the details. I am still uncertain as to what his EXACT position will be.

And Lisa, the PT is extremely easy. So, it isn't all that bad. But, yep, I sat on those metal chairs for about an hour or so and just couldn't take it anymore. If I had thought to do so, I would have taken my 1/2 of a Vicodin before I went. Anyway, I had to tell my mom...let's hit it...I am dying here! LOL My sister and my daughter would have sat for hours and talked if we had let them. :)

Okay, well, I have been ironing for most of the day and I am taking a break! Time to lie down for awhile...ugh...still tired! LOL