Career Ending Operation???

[pro1driver]

Re: the nurse case manager. She had called me last week and said that she wants to meet me at the doctors office. we have talked a lot on the phone, but that's about all. As advised by my lawyer several months ago, as i was still under Concentra's thumb, the lawyer told me he forbids any nurse case manager (or anyone connected to the insurance company) to be in the examining room with me and the doctor. he said it's "ok" to talk with her outside the examining room and not to sign anything. that is common sense of course, but i suppose under the wrong circumstances, some do sign papers.

as far as building the core, i am sure i have been told to tighten up my stomach and such, but i do not think i am doing it properly. the gal watches me at times, but then some days she has several patients so time with me is short or at best not one on one. so if i am doing something wrong i don't think i am catching it as quickly as she should, if there was one on one therapy.

whether it be pushing/pulling that wooden box, or using the cable machine, i have no upper body strength to hold it into position, as it is heavy, and pulls me into the machine. there have been times, especially at first, i needed 2 hands to pull just the one cable. she wants me to stand straight, but the weight pulling me, makes me stand awkward to avoid being sucked into the machine. as for the wooden box, it pains to pull it back.

if the p/t gal is writing down the fact that i am removing weights, i say good. she gets the message it's too heavy, after i had already told her it was. if no one wants to listen, then my actions will speak. i'd like to just say "F" it and stop p/t till something is done about the way it is going, but stopping may signal no cooperation from me, and that can be a problem with the insurance company.

one other thing i did forget to mention in the update, and that is, my right leg still goes numb, when ever it wishes to. this cannot be normal.

 

[Dockworker]

Re: the nurse case manager. She had called me last week and said that she wants to meet me at the doctors office. we have talked a lot on the phone, but that's about all. As advised by my lawyer several months ago, as i was still under Concentra's thumb, the lawyer told me he forbids any nurse case manager (or anyone connected to the insurance company) to be in the examining room with me and the doctor. he said it's "ok" to talk with her outside the examining room and not to sign anything. that is common sense of course, but i suppose under the wrong circumstances, some do sign papers.

I understand how there seems to be a line drawn in the sand between work comp and attorney/patient but it's not uncommon to have them there. They act as the liason but more than often are seen as the enemy who tries to put a rush on things. In reality, the work comp nurse does have the right to meet up with you a few times to see how things are going since they are the ones paying for your therapy, surgery etc....they do have a vested interest in your recovery. Most attorneys, especially the ones who have a full grasp of your case don't mind them being there and will advise that you not be a Chatty Cathy when it comes to your case. You can turn them away a few time but sooner or later, she will be fused to you. (pun intended)
Usually the nurse comes in and announces herself to the front desk, they in turn tell the doctor who that person is. Than you meet with your doctor first ask all the questions you can ask per doctor/patient confidentiality. After all your questions have been answered. (Remember write them down prior) than he invites her over.
This is when your doctor tells the nurse what he just told you, no surprises. The nurse takes notes, and might ask questions etc. She pretty much gets up to the minute current updates on your situation which in turn she turns in to her superiors. As long as the truth is told on all three sides, there is nothing to hide, your all transparent and everyone is on the same page.

as far as building the core, i am sure i have been told to tighten up my stomach and such, but i do not think i am doing it properly. the gal watches me at times, but then some days she has several patients so time with me is short or at best not one on one. so if i am doing something wrong i don't think i am catching it as quickly as she should, if there was one on one therapy.

Not trying to bust your chops but usually they instruct you a few times, maybe touch your belly to see if your abs are tight and than expect you to remember that and do it from there on out. It is easy to forget and start relying on sheer arm or spine strength.
They do meet with other patients and usually overlap their times so you are not getting the full 30-minutes to 1 hour of your total therapy one on one time with them. Probably just enough to do some updating, initial massaging, stretching, introducing you to new stuff, send you on your own to do what you've learned and when completed do some icing or heat. The therapist should at least make a round to see how your doing.

whether it be pushing/pulling that wooden box, or using the cable machine, i have no upper body strength to hold it into position, as it is heavy, and pulls me into the machine. there have been times, especially at first, i needed 2 hands to pull just the one cable. she wants me to stand straight, but the weight pulling me, makes me stand awkward to avoid being sucked into the machine. as for the wooden box, it pains to pull it back.

Most people feel they have no upper body strength, they do, we all do, It's not like they are going for Mr. America strength. Were you the guy in the Charles Atlas comic ads that got sand kicked in face by a hulking bully? just kidding.
Two hands to pull the weight is to keep you centered and build core strength evenly. (geez I over use the word "core")
When your strength comes back you can probably rely on one hand. However, at this point, your muscles and spine are not ready for it, so you take the baby steps. In the end as we get older and more brittle we are better off in life using two hands as that forces us to be center with things.
Weight pulling you back? Try to support the resistance using your leg strength too a little lean back with abs tightened makes a world of difference. Don't let that equipment bully you.

if the p/t gal is writing down the fact that i am removing weights, i say good. she gets the message it's too heavy, after i had already told her it was. if no one wants to listen, then my actions will speak. i'd like to just say "F" it and stop p/t till something is done about the way it is going, but stopping may signal no cooperation from em, and that can be a problem with the insurance company.

You are right, you are obligated to go to therapy for both continued work comp coverage and your own healing. If it really hurts and you just can't get yourself to try it than put your foot down and tell them it hurts, refuse to attempt it unless they lower the weight to a more repetitious level to get more out of you.

This is just for comedy and mood lightening:
I would love to read the notes, probably says a few nasty things about you. Jerk, cry baby, whiner, needs a milk bottle at times, needs to wear a dress instead of pants that wuss, tough guy needs diapers when lifting 2 pounds. His stitches are healing but look like the Mississippi river line who's the doctor so we can never use them. Wish I had magnets to toss on him and see if they stick. When I see him pull in I wish I could punch out and go home. Its fun to put more weight on him than necessary just to torture him, I'll just put in half that weight in my notes. Played a game called "put on pull off" with weights. I won.

Again that was just for fun....You can't have a Happy Holiday being in so much pain,but try not to have a Crappy Holiday and make the best of it.

 

[pro1driver]

some of us in the therapy often say, "here we are, at Missy's house of torture". i know she is educated and has experience. i know she cannot be with me 100% of the time. but it gets annoying to continually complain about the pain that is there, steady and shoots to the sky at times.

as far as wearing dresses.......not since my "experimental years"....

and as far as having a Happy Christmas...???

bah-humbah........i was told i ain't getting a pony this year again......

 

[pro1driver]

UGLY UPDATE

ok, so i get to the doctors office a few minutes early, get some forms to update. the nurse case manager to be known as (ncm) from this point on, walks in, says who she is and sits next to me. our first in person meting. as i am filling out the update forms, the gal behind the desk, slides open the glass door and says something like, "we are waiting for doctor x to call us, he is not here, he is in surgery"........

i am thinking and the ncm is thinking, W..T...F....

my appointment was cancelled and rescheduled to today because back in November, 2 days before T-Day, he was in surgery as well. ncm got mad as all hell. but held back a bit. i asked the gal at the desk, what do i do, you don't know when he will be back, what do i do? she said she will reschedule this one as well.

now mind you, i got that "call yesterday to CONFIRM my appointment".....!!!!!!

so then the ncm said i may have to get "a note" to give to her, so she could fax it to the insurance company to say that I DID NOT get to see the doctor, and so that my checks will still come to me, otherwise, the insurance can stop. oh great, i start sweating, i get the usual bills to pay, that a home owner has, like insurance, taxes, mortgages, you know, nothing important..right.>??

so now my "new appointment" is for March....

i still need meds, the ncm voiced herself over that, she voiced herself over the appointment cancellations, and HOW IN THE ELL DO YOU schedule an all important appointment to see YOUR patient, and not even be there for him..???
oh and by the way..there wasn't ONE P/A to see me either........!!!! other patients were going in, but not me...????

the ncm was livid.....i was holding back since i did not know what to say, then make it worse for me.

so there you have it...i have to keep my fingers crossed for a cancelled appointment, which that office being what it is, it'll either never happen (a patient cancelling) or them calling me to get in sooner. now before all of this stupid horse pucky, the ncm told me the guy is a surgeon, if he sees the area healed up but i am still in pain, he will have to refer me to a pain management doctor for shots, and a different type of therapy, or some horse sheet like that.
right now, i had to type up something for my lawyer, i am typing this all up, i still got some errands to run, the holiday is a day away, and my head is pounding like no one would believe.

a short time ago when i stopped by at Walgreen's to get my other needed meds, the gal asked me, how am i doing today.

i told her, not bad, if i die before sundown.

 

[Dockworker]

UGLY UPDATE

ok, so i get to the doctors office a few minutes early, get some forms to update. the nurse case manager to be known as (ncm) from this point on, walks in, says who she is and sits next to me. our first in person meting. as i am filling out the update forms, the gal behind the desk, slides open the glass door and says something like, "we are waiting for doctor x to call us, he is not here, he is in surgery"........

i am thinking and the ncm is thinking, W..T...F....

my appointment was cancelled and rescheduled to today because back in November, 2 days before T-Day, he was in surgery as well. ncm got mad as all hell. but held back a bit. i asked the gal at the desk, what do i do, you don't know when he will be back, what do i do? she said she will reschedule this one as well.

now mind you, i got that "call yesterday to CONFIRM my appointment".....!!!!!!

Incompetent office staff who has no clue how to follow up correctly, correctly confirm appointments or when the doctor will be in office or cutting into someone.

so then the ncm said i may have to get "a note" to give to her, so she could fax it to the insurance company to say that I DID NOT get to see the doctor, and so that my checks will still come to me, otherwise, the insurance can stop. oh great, i start sweating, i get the usual bills to pay, that a home owner has, like insurance, taxes, mortgages, you know, nothing important..right.>??

so now my "new appointment" is for March....

An appointment in March would be totally unacceptable for me. You should be seeing the doctor at least one a month for status updates while you are healing.
Even work comp wants to see doctor appointments scheduled every 30 days. It's so they can keep work comp benefits flowing without interruption. Damn, you haven't seen a doctor since November. Did they give a reason why it would be in March?
At least the NCM was there to witness you getting bent over the coals. The NCM will probably intervene and try to get more answers and get you an earlier appointment.

i still need meds, the ncm voiced herself over that, she voiced herself over the appointment cancellations, and HOW IN THE ELL DO YOU schedule an all important appointment to see YOUR patient, and not even be there for him..???
oh and by the way..there wasn't ONE P/A to see me either........!!!! other patients were going in, but not me...????

the ncm was livid.....i was holding back since i did not know what to say, then make it worse for me.

You did the right thing by keeping quiet but it's okay to be cordial towards her and discuss minor non significant things about your healing.
Did you tell her that you were not improving while in therapy? They might not continue therapy until the doctor sees you to discuss the non healing issue, put you on a bare bones program to keep you from staying stagnant or have you see another doctor. What a mess!

so there you have it...i have to keep my fingers crossed for a cancelled appointment, which that office being what it is, it'll either never happen (a patient cancelling) or them calling me to get in sooner. now before all of this stupid horse pucky, the ncm told me the guy is a surgeon, if he sees the area healed up but i am still in pain, he will have to refer me to a pain management doctor for shots, and a different type of therapy, or some horse sheet like that.
right now, i had to type up something for my lawyer, i am typing this all up, i still got some errands to run, the holiday is a day away, and my head is pounding like no one would believe.

Your surgeon should discuss the surgery, what he see's in the last X-ray, get a new X-ray, give a reason why you aren't healing properly, give you a worse case scenario of a possible corrective surgery.
I can't see them referring you to a pain management doctor to give you shots. that's kind of defeats the purpose of a fusion. You normally get the shot way before the surgery ever happens. That's if the shot is an epidural. Than again, they will probably try their best to do everything they can to stay away from another surgery.
It's almost like your own doctor office is the ones screwing with you now.

Too bad you got your appointment cancelled. I was curious to find out what the doctor's thoughts were.

Now that you have the NCM fused to you, take her to lunch. Good Luck

 

[pro1driver]

Incompetent office staff who has no clue how to follow up correctly, correctly confirm appointments or when the doctor will be in office or cutting into someone.

you should see the comments people write about the office staff on the website. they do not all speak nicely of the staff.

An appointment in March would be totally unacceptable for me. You should be seeing the doctor at least one a month for status updates while you are healing.
Even work comp wants to see doctor appointments scheduled every 30 days. It's so they can keep work comp benefits flowing without interruption. Damn, you haven't seen a doctor since November. Did they give a reason why it would be in March?
At least the NCM was there to witness you getting bent over the coals. The NCM will probably intervene and try to get more answers and get you an earlier appointment.

the March appointment is not ok with me as well, but i hope the checks do not stop either, and since the ncm was there, i think she will speak up for me to the insurance co.

as for the November appointment, i never even got to go there then, as it was cancelled because he was in surgery that day too. i cannot remember the last actual date i was there, and when i was, i had seen the doctors, P/A. that "might have been" in Sept..??? when i got that stupid spine bone growth stimulator.

You did the right thing by keeping quiet but it's okay to be cordial towards her and discuss minor non significant things about your healing.
Did you tell her that you were not improving while in therapy? They might not continue therapy until the doctor sees you to discuss the non healing issue, put you on a bare bones program to keep you from staying stagnant or have you see another doctor. What a mess!

yeah, we had "small chit-chat, and as i said, i really would not have known the right things to say to the office staff (i know what i COULD HAVE said), but by not blowing my top and letting the ncm take over, i thought that safest to do. i did tell the ncm that the gal in therapy said i either was not improving or getting better, this is when she said the doctor is a surgeon and if he see's healing and nothing he can do for the pain, he might, might refer me to a pain management doctor/clinic/therapy place other than himself, and i told her (the ncm) i hope the checks don't stop coming in while i go through that. she said the checks would keep coming in. (as a matter of reference) in my state, under law, one can be on comp for 6 years.

Your surgeon should discuss the surgery, what he see's in the last X-ray, get a new X-ray, give a reason why you aren't healing properly, give you a worse case scenario of a possible corrective surgery.
I can't see them referring you to a pain management doctor to give you shots. that's kind of defeats the purpose of a fusion. You normally get the shot way before the surgery ever happens. That's if the shot is an epidural. Than again, they will probably try their best to do everything they can to stay away from another surgery.
It's almost like your own doctor office is the ones screwing with you now.

well, when and IF i ever get to actually see him again, (outside of one pre-op discussion), i have had the x-ray he needs to see, back in November. i had asked today, "do i have to get yet another x-ray"? the desk gal said no. i thought the "shots idea" was basackwards, but hey, i ain't the professional medical person, only the professional in pain patient.

Too bad you got your appointment cancelled. I was curious to find out what the doctor's thoughts were.

Now that you have the NCM fused to you, take her to lunch. Good Luck

well, i'd like to know what he had to say, then again, the office staff could say that i cancelled....so all i can do is take the typed up "letter" i composed earlier, before i posted here, and talk with my lawyer on Monday of next week. so at least the ncm, AND the lawyer can "see" the office staff is the problem more so than the doctor's absence?
(having the ncm there and seeing what she saw, i highly doubt that she will call the doctor and speak with him over what has happened a second time.) i wonder now, if the insurance company CAN STOP payments till i see the doc or a p/a? dammit, my mind has started racing again.

as far as any lunch is concerned, yeah, i should maybe think about that. can't say how old the ncm is, but certainly of course, when you hear someone over the phone you get ideas on what they look like. of course i had a "feeling" she was over weight, but she was not, far from it. and she is maybe in her 50's..??? if i had the time, i would have made it a point to check her "ring finger", but the way things were going in that office, and my getting heated up with nervousness, literally getting heated, so much so, the sweat was showing through my colored T-shirt, and it was embarrassing. i was more worried about the future of the comp claim and what turns (for the worse) it could take.

it's like here, i "talk" with you several times, but don't know what YOU look like, but i imagine from your words, and your typing skills, and knowledge, you look like this.....

 

[Dockworker]

Quincy M.E! I used to love that show. I wish I had his money too.
Thanks for the compliments. I follow your story because it's very interesting and intriguing to follow the road to recovery.

Too bad the office staff is incompetent. Now you have to spend extra energy resources fact checking them.
I've never heard of a doctor's office doing something like that to a patient. Pushing your appointment further and further away when you are struggling in therapy. Makes you wonder if a change in venue is an option.

Since you haven't seen a doctor since October? You will definitely need another x-ray. They can't go by that previous x-ray done many months ago, things change for the better or worse.
Things change month after month and you probably have some kind of fusing, advancing spondylolysis/spondylolisthesis, (If that's what the curvature of your spine turns out to be) I can almost guarantee your NCM would think an updated X-ray is necessary.

When I said the NCM would try to see if they could get an earlier appointment for you, I meant she would talk to the office staff, not the doctor himself, see and confirm that he would be "in" office seeing patients not doing surgeries.

I was kidding about lunch with NCM, although I have seen cases of romance happening in odd places. Again....good luck keep on the bright side of of the Serenity Prayer....keep trying to walk and Happy Holidays.

Random Silly Pictures reflecting our previous replies to pass the time, until you see your doctor in the Spring if not sooner.

Room is empty...it's very busy though

Playing the Push Pull weight game.

Hold In Abs Not Breath

BFF fused to patient.

New Alternate Therapy while waiting for doctor recommendations

 

[Getoverit]

UGLY UPDATE

ok, so i get to the doctors office a few minutes early, get some forms to update. the nurse case manager to be known as (ncm) from this point on, walks in, says who she is and sits next to me. our first in person meting. as i am filling out the update forms, the gal behind the desk, slides open the glass door and says something like, "we are waiting for doctor x to call us, he is not here, he is in surgery"........

i am thinking and the ncm is thinking, W..T...F....

my appointment was cancelled and rescheduled to today because back in November, 2 days before T-Day, he was in surgery as well. ncm got mad as all hell. but held back a bit. i asked the gal at the desk, what do i do, you don't know when he will be back, what do i do? she said she will reschedule this one as well.

now mind you, i got that "call yesterday to CONFIRM my appointment".....!!!!!!

so then the ncm said i may have to get "a note" to give to her, so she could fax it to the insurance company to say that I DID NOT get to see the doctor, and so that my checks will still come to me, otherwise, the insurance can stop. oh great, i start sweating, i get the usual bills to pay, that a home owner has, like insurance, taxes, mortgages, you know, nothing important..right.>??

so now my "new appointment" is for March....

i still need meds, the ncm voiced herself over that, she voiced herself over the appointment cancellations, and HOW IN THE ELL DO YOU schedule an all important appointment to see YOUR patient, and not even be there for him..???
oh and by the way..there wasn't ONE P/A to see me either........!!!! other patients were going in, but not me...????

the ncm was livid.....i was holding back since i did not know what to say, then make it worse for me.

so there you have it...i have to keep my fingers crossed for a cancelled appointment, which that office being what it is, it'll either never happen (a patient cancelling) or them calling me to get in sooner. now before all of this stupid horse pucky, the ncm told me the guy is a surgeon, if he sees the area healed up but i am still in pain, he will have to refer me to a pain management doctor for shots, and a different type of therapy, or some horse sheet like that.
right now, i had to type up something for my lawyer, i am typing this all up, i still got some errands to run, the holiday is a day away, and my head is pounding like no one would believe.

a short time ago when i stopped by at Walgreen's to get my other needed meds, the gal asked me, how am i doing today.

i told her, not bad, if i die before sundown.

Is this the doctor your company sent you to?? If so I would just ride it out as long as your getting your money. If it's like my employer they choose the doctor you see!

 

[Getoverit]

you should see the comments people write about the office staff on the website. they do not all speak nicely of the staff.




the March appointment is not ok with me as well, but i hope the checks do not stop either, and since the ncm was there, i think she will speak up for me to the insurance co.

as for the November appointment, i never even got to go there then, as it was cancelled because he was in surgery that day too. i cannot remember the last actual date i was there, and when i was, i had seen the doctors, P/A. that "might have been" in Sept..??? when i got that stupid spine bone growth stimulator.



yeah, we had "small chit-chat, and as i said, i really would not have known the right things to say to the office staff (i know what i COULD HAVE said), but by not blowing my top and letting the ncm take over, i thought that safest to do. i did tell the ncm that the gal in therapy said i either was not improving or getting better, this is when she said the doctor is a surgeon and if he see's healing and nothing he can do for the pain, he might, might refer me to a pain management doctor/clinic/therapy place other than himself, and i told her (the ncm) i hope the checks don't stop coming in while i go through that. she said the checks would keep coming in. (as a matter of reference) in my state, under law, one can be on comp for 6 years.



well, when and IF i ever get to actually see him again, (outside of one pre-op discussion), i have had the x-ray he needs to see, back in November. i had asked today, "do i have to get yet another x-ray"? the desk gal said no. i thought the "shots idea" was basackwards, but hey, i ain't the professional medical person, only the professional in pain patient.



well, i'd like to know what he had to say, then again, the office staff could say that i cancelled....so all i can do is take the typed up "letter" i composed earlier, before i posted here, and talk with my lawyer on Monday of next week. so at least the ncm, AND the lawyer can "see" the office staff is the problem more so than the doctor's absence?
(having the ncm there and seeing what she saw, i highly doubt that she will call the doctor and speak with him over what has happened a second time.) i wonder now, if the insurance company CAN STOP payments till i see the doc or a p/a? dammit, my mind has started racing again.

as far as any lunch is concerned, yeah, i should maybe think about that. can't say how old the ncm is, but certainly of course, when you hear someone over the phone you get ideas on what they look like. of course i had a "feeling" she was over weight, but she was not, far from it. and she is maybe in her 50's..??? if i had the time, i would have made it a point to check her "ring finger", but the way things were going in that office, and my getting heated up with nervousness, literally getting heated, so much so, the sweat was showing through my colored T-shirt, and it was embarrassing. i was more worried about the future of the comp claim and what turns (for the worse) it could take.

it's like here, i "talk" with you several times, but don't know what YOU look like, but i imagine from your words, and your typing skills, and knowledge, you look like this.....

All those shots do is mask the pain, the problem is still there. I would think an MRI should be done over an X-RAY! I'm going thru the same thing except mine is not workmanscomp, I'm on my own on this. I'm sure mine is work related, but I didn't go that route... Good Luck!! I would so no on the shots, after so many of them they stop working and then what??

 

[pro1driver]

Is this the doctor your company sent you to?? If so I would just ride it out as long as your getting your money. If it's like my employer they choose the doctor you see!

Well it's like this, my company sent me to "Concentra". The doctors at that place treated me and put me into a therapy phase. The first doctor, was in my opinion, a sweet heart. when i described the problem she said to me, "what you are explaining sounds like the L-5 disk is bad. The following week, she wasn't there the day i went back for a check up. Instead, some QUACK of a so-called doctor said i was having a back spasm and said i can go back to work. I IMMEDIATELY DEMANDED and x-ray AND an MRI. this was not my first rodeo with a back problem, as i knew the pain all too well. Quack says, it's too soon, nothing will show up.

fast forward several weeks, i go for yet another of my weekly visits (all the while being on comp). a doctor's p/a examined me, and now my other leg is going numb. he says, "it's time for an MRI, i think something is wrong"

i felt like saying...NO SHYTE SHERLOCK, but i said instead, it's about time, someone listened to me.

so i get the x-rays AND MRI, shows L-5 disk bad, like the sweet heart first doctor said.

now i need a surgeon, so Concentra's HQ, that sets up such things, tells me of a doctor, i go to him, talk to him, and i actually liked his over all knowledge, and believe it or not, he IS ranked in the upper top ten of neurologists in my state!!! it's his office staff that suck. they have a "surgical coordinator" that sets up ALL of his surgeries. but yet, there is a lack of communication between that guy and the other office staff.

so yeah, hey they gotta STILL PAY ME (the comp insurance) till i am discharged not only by him mind you, if he says he cannot do any more for me, as he is ONLY a surgeon, then i was told i should be and will be referred to a pain management doctor, and therapy at that place. so in MY state, by law, i can be on comp for 6 years.

so there have it, a LONG tale to your specific question.

 

[Getoverit]

Well it's like this, my company sent me to "Concentra". The doctors at that place treated me and put me into a therapy phase. The first doctor, was in my opinion, a sweet heart. when i described the problem she said to me, "what you are explaining sounds like the L-5 disk is bad. The following week, she wasn't there the day i went back for a check up. Instead, some QUACK of a so-called doctor said i was having a back spasm and said i can go back to work. I IMMEDIATELY DEMANDED and x-ray AND an MRI. this was not my first rodeo with a back problem, as i knew the pain all too well. Quack says, it's too soon, nothing will show up.

fast forward several weeks, i go for yet another of my weekly visits (all the while being on comp). a doctor's p/a examined me, and now my other leg is going numb. he says, "it's time for an MRI, i think something is wrong"

i felt like saying...NO SHYTE SHERLOCK, but i said instead, it's about time, someone listened to me.

so i get the x-rays AND MRI, shows L-5 disk bad, like the sweet heart first doctor said.

now i need a surgeon, so Concentra's HQ, that sets up such things, tells me of a doctor, i go to him, talk to him, and i actually liked his over all knowledge, and believe it or not, he IS ranked in the upper top ten of neurologists in my state!!! it's his office staff that suck. they have a "surgical coordinator" that sets up ALL of his surgeries. but yet, there is a lack of communication between that guy and the other office staff.

so yeah, hey they gotta STILL PAY ME (the comp insurance) till i am discharged not only by him mind you, if he says he cannot do any more for me, as he is ONLY a surgeon, then i was told i should be and will be referred to a pain management doctor, and therapy at that place. so in MY state, by law, i can be on comp for 6 years.

so there have it, a LONG tale to your specific question.

I'm sorry I said the company picked the doctor, the workers comp people we have are the ones who pick the doctor one see's!!

 

[pro1driver]

I'm sorry I said the company picked the doctor, the workers comp people we have are the ones who pick the doctor one see's!!

By state law (here) I could have gone anywhere for my first treatment. But I went to the "company preferred place" as to it not being construed i was not going to cooperate and then be told, well then you ain't hurt go back to work, or get fired.

I choose the surgeon as i said because his education, at Johns Hopkins and Columbia. He is/was a professor at Brown and Boston University as well. He is head of neurosurgery at the hospital i was operated at. with his educational background and other medical involvements, and being in the upper top 10 of neurosurgeons, i think i had a good doctor. it's just that his office staff make the big sucking sound.

but in the future, if i ever need another back operation, i will most certainly seek out another doctor, and i'm somewhat sure, that other doctor will have a better office staff. i mean after all, it can't get any worse, can it..??????

 

[pro1driver]

UPDATE:

ok, last week i told you all of the doctor not being in his office for my visit, and how i had to reschedule again. I told you that my "nurse case manager" (ncm) was there with me as well. you all should know the ncm works for the insurance company and is my "advocate and go-between" for me when i have to contact the insurance company with questions as they will not talk to me, as i have a lawyer.

ok, i also told you all that i have an appointment today, this afternoon in fact, with my lawyer, to discuss that day of the cancelled appointment, plus i had other questions.

so in today's mail, i get a letter form another doctors office, stating that they were contacted by them, for me to go there for an examination.

it says that it is for an "independent medical examination", something in which i believe dockworker has told me about. if i do not show up, i can lose any benefits, so of course, i will be there, and this will happen in February. this happens to be a doctor that is an orthopedic surgeon and i do believe i had been there back in the 1990's when i had shoulder injury, and although i cannot remember every little detail, i think he was the doctor that treated me, and was not an IME for me back then. if they kept up thier data base, i should still be in there, wouldn't you think, even though it goes back to the 1990's..???

come snow or high water or the wrath of the devil, i will be there. (unless i drop dead first, or i hit the lottery)

when i see my lawyer this afternoon, he will be asked questions regarding this. i know he should have received the same letter as they CC'd it to him as well.

i had p/t this morning, and the gal can plainly see that i cannot lift more that about 10-20 pounds. again, some weight had to be taken out of the "box" for me to pull it back. pushing was easier, but pulling it back really puts the hurt on the back.

she also told me that if the p/t place can get anymore p/t for me, it might only be for about 4 weeks, so it'll be "close" to that February IME. there can be more p/t, but at a state run facility, for w/c people at no cost to me, and oh yeah, no cost to the insurance company as well. i am sure the insurance company wants to make cut backs somewhere along the line.

one of the questions i will ask the lawyer is, can the insurance company demand my surgeon cut me loose? if the IME says i am not good to go back to work, does he take over my treatments? i know my surgeon would have to "refer me" to another doctor, but can the insurance company make demands of him, in releasing me?

so there it is, another update. if the lawyer says anything important, i will mention some of it later tonight. or i must just update for da heck of it.

 

[pro1driver]

i just read a very informative report on IME's

http://www.badfaithinsurance.org/reference/HL/0090a.pdf

 

[Dockworker]

UPDATE:

ok, last week i told you all of the doctor not being in his office for my visit, and how i had to reschedule again. I told you that my "nurse case manager" (ncm) was there with me as well. you all should know the ncm works for the insurance company and is my "advocate and go-between" for me when i have to contact the insurance company with questions as they will not talk to me, as i have a lawyer.

ok, i also told you all that i have an appointment today, this afternoon in fact, with my lawyer, to discuss that day of the cancelled appointment, plus i had other questions.

so in today's mail, i get a letter form another doctors office, stating that they were contacted by them, for me to go there for an examination.

it says that it is for an "independent medical examination", something in which i believe dockworker has told me about. if i do not show up, i can lose any benefits, so of course, i will be there, and this will happen in February. this happens to be a doctor that is an orthopedic surgeon and i do believe i had been there back in the 1990's when i had shoulder injury, and although i cannot remember every little detail, i think he was the doctor that treated me, and was not an IME for me back then. if they kept up thier data base, i should still be in there, wouldn't you think, even though it goes back to the 1990's..???

come snow or high water or the wrath of the devil, i will be there. (unless i drop dead first, or i hit the lottery)

Good luck with your IME. You might still be in the system from the 90's but this is a whole new territory you are treading with them. There are usually two IME's set months apart. This is so they can compare notes.
Your attorney show also be notified. IME place should have sent you a letter and a check to cover mileage, gas,time. (I'm guessing 20-30 dollars) They also state that you not come in with any recording devices.
I wonder if an Attorney can attend?

IME's are not looking out for your best interest. They come into the picture because things are progressing slower than normal, more evidence is needed to deny or limit the amount of treatments you receive. Work comp/employer wants the answers, and the IME doctor knows what kinds of answers are needed to satisfy the ones paying the bill. (Work comp/employer). Your impairment rating won't reflect your continued pain. It's usually on the good side.

The exam can start as early as you walking in and I'D ing yourself. They will come off as super friendly and accommodating as they watch you. When you are in the exam room, who knows maybe they have some kind of a secret camera (I doubt it but you never know). Nurse probably starts taking initial notes. (Your answers should reflect your pain when NOT on meds. Meds mask and therefore you do not get a true assessment)
They tag team you in the room. The doctor and a nurse who writes notes down. Doctor makes small talk and than measures you quickly, start touching you, making you bend, walk etc. and they do some trick exam that has nothing to do with your situation. It is there to spot a malingerer/faker. They are dictating out loud while the nurse is writing it down.

You can complain, show aches and pains, limited mobility and in the end they don't really care, you are on the road to recovery as far as they are concerned. They will play a violin in their minds as you complain. Limit your answers and do not elaborate because you are totally wasting your time and they are NOT your treating doctor. All they know is you had spinal fusion and are so and so months past surgery, there is no incentive for them to know your whole case history. They might even take a few x-rays and tell you they will discuss them with you. They won't discuss and you'll be on your way wondering what just happened.

when i see my lawyer this afternoon, he will be asked questions regarding this. i know he should have received the same letter as they CC'd it to him as well.

i had p/t this morning, and the gal can plainly see that i cannot lift more that about 10-20 pounds. again, some weight had to be taken out of the "box" for me to pull it back. pushing was easier, but pulling it back really puts the hurt on the back.

she also told me that if the p/t place can get anymore p/t for me, it might only be for about 4 weeks, so it'll be "close" to that February IME. there can be more p/t, but at a state run facility, for w/c people at no cost to me, and oh yeah, no cost to the insurance company as well. i am sure the insurance company wants to make cut backs somewhere along the line.

I think fusion patients are allowed up to 32 PT sessions, after that you go into a work conditioning program. I'm not sure what happens if your PT sessions are not working, it does seem like you are just going through the motions while your PT rakes in the money off work comp as your doctor appointments get pushed into the future. Might be something to discuss with your attorney. (not making progress but still attending therapy?)

one of the questions i will ask the lawyer is, can the insurance company demand my surgeon cut me loose? if the IME says i am not good to go back to work, does he take over my treatments? i know my surgeon would have to "refer me" to another doctor, but can the insurance company make demands of him, in releasing me?

The IME is supposed to give them a fairly accurate assessment to what's wrong with you. Again, it errs towards the employer side. If you truly are in that much pain, I think your IME should reflect that.
I hope they do not try to make you appear 85-90 percent healed when you are 60-70 percent healed.
They might try to poke and prod your doctor but if your doctor is good he/she will remain steadfast knowing their course of treatment with you is within the time frame of spinal fusion healing.
IMO I think you might even have to light a fire under the doctor.


In the end when you go in for IME expect it to already be in progress as you are in the waiting room. Sometimes starts if they get lucky and spot you from outside. Be truthful and if you are in pain tell them. Give brief answers and don't elaborate.
Word of advice with NCM, even though they are liasons and very easy to talk to, they are bound by the same employer who is paying your work comp bills and therefore anything you say can and will be used against you. The IME has nothing to do with improving your pain/treatment, that's your doctors responsibility.
Don't fall for the I love you but I'm not IN love with you trap.

 

[Dockworker]

i just read a very informative report on IME's

http://www.badfaithinsurance.org/reference/HL/0090a.pdf

That's good stuff that people should really read.

 

[pro1driver]

Good luck with your IME. You might still be in the system from the 90's but this is a whole new territory you are treading with them. There are usually two IME's set months apart. This is so they can compare notes.
Your attorney show also be notified. IME place should have sent you a letter and a check to cover mileage, gas,time. (I'm guessing 20-30 dollars) They also state that you not come in with any recording devices.
I wonder if an Attorney can attend?

My lawyer's office got the same letter as I did yesterday. All i got was the letter, no check to cover miles, in fact the insurance adjuster told me (before i got the lawyer, they DO NOT PAY miles, etc,etc). but i certainly HAVE BEEN documenting miles, dates to therapy, doctors, etc,etc. if they will not reimburse me, i do know that my accountant can find a way, it is something he always asks me, "any miles to and from doctors"?

I asked lawyer, does he send someone with me to the IME? he said no. i CAN TAKE someone he said, and that would be ANOTHER doctor, but not too many doctors avail themselves for this service.

The IME doctors office letter to me said to bring any x-rays, MRI's to them as well...lawyer said NO, they want them, they can get them. we are not there to serve them, make them work for thier money. i asked, are you 1000% certain about that, i read where it goes to show i am NOT cooperating?? he said YOU ARE cooperating, you showed up, and you took your driver's license with you for an ID, and you are there for the exam, you HAVE NO OTHER OBLIGATION.........

IME's are not looking out for your best interest. They come into the picture because things are progressing slower than normal, more evidence is needed to deny or limit the amount of treatments you receive. Work comp/employer wants the answers, and the IME doctor knows what kinds of answers are needed to satisfy the ones paying the bill. (Work comp/employer). Your impairment rating won't reflect your continued pain. It's usually on the good side.

lawyer said he knows the IME doctor, in fact has sent his own family members there for treatment, surgery etc. says the guy is fair, upstanding and not entirely towards the insurance company nor the patient. but not totally in the middle, he may "lean a bit" towards the insurance co, but it is not a full guarantee each time, which is why my lawyer was satisfied with him....i guess one of the benefits of a small state, and a pro at workman's comp cases, you get to know how the doctors are and where they lean towards.

The exam can start as early as you walking in and I'D ing yourself. They will come off as super friendly and accommodating as they watch you. When you are in the exam room, who knows maybe they have some kind of a secret camera (I doubt it but you never know). Nurse probably starts taking initial notes. (Your answers should reflect your pain when NOT on meds. Meds mask and therefore you do not get a true assessment)
They tag team you in the room. The doctor and a nurse who writes notes down. Doctor makes small talk and than measures you quickly, start touching you, making you bend, walk etc. and they do some trick exam that has nothing to do with your situation. It is there to spot a malingerer/faker. They are dictating out loud while the nurse is writing it down.

well considering i can barely walk fully standing up straight now as it is, if they do have a camera on me, they will see my nearly "Hunchback of Notre Dame" walk.

You can complain, show aches and pains, limited mobility and in the end they don't really care, you are on the road to recovery as far as they are concerned. They will play a violin in their minds as you complain. Limit your answers and do not elaborate because you are totally wasting your time and they are NOT your treating doctor. All they know is you had spinal fusion and are so and so months past surgery, there is no incentive for them to know your whole case history. They might even take a few x-rays and tell you they will discuss them with you. They won't discuss and you'll be on your way wondering what just happened.

after reading that webpage i linked here, and from p/t sessions, i can honestly say i complain of pain when it is there, meaning movement of some type. when the gal pressed on my back, my right leg jumped when she pressed in a certain spot. if the doctor does the same, i can only hope it happens then as well. something just ain't right with that leg, and the nerves there.

I think fusion patients are allowed up to 32 PT sessions, after that you go into a work conditioning program. I'm not sure what happens if your PT sessions are not working, it does seem like you are just going through the motions while your PT rakes in the money off work comp as your doctor appointments get pushed into the future. Might be something to discuss with your attorney. (not making progress but still attending therapy?)

well if it is 32 p/t visits, and just looking up all my times with this current place, monday of next week will be the 25th time (and last till until they can get more visits). which simple math, leaves me with 7 more visits. however gal there said they may only be able to get 4 more..??? and if i get bounced out of there, i will have to go to a state run p/t place, free of charge to me and of course, free to the insurance co as well.... lawyer of course when i speak with him in person or from updated letters i drop off, knows the pain is still there as well as movement limitations. for instance, i still cannot bend to touch my toes, in fact cannot bend very much, if i could tell you my measured limit i would. (best i can say is that i can only bend forward enough to touch my upper thighs, way above my knee joints..???) i cannot twist my body side to side like i once did. cannot sit, stand or lay flat for too long. cannot sleep through the night, i cannot lean down to say work the garden nor can i lean forward like over the kitchen table to prepare foods, and regarding sleeping and lack of it, i refuse to get hooked on sleeping aids.

The IME is supposed to give them a fairly accurate assessment to what's wrong with you. Again, it errs towards the employer side. If you truly are in that much pain, I think your IME should reflect that.
I hope they do not try to make you appear 85-90 percent healed when you are 60-70 percent healed.
They might try to poke and prod your doctor but if your doctor is good he/she will remain steadfast knowing their course of treatment with you is within the time frame of spinal fusion healing.
IMO I think you might even have to light a fire under the doctor.

doctor does not have to give me his report, or speak to me as to the outcome of the visit. by state law, the insurance company sends me a copy of his report, and a copy to the lawyer. there may be a "time frame" for healing, but i venture to guess if it encompasses all ages, and both sexes, or is it age group related??? does it include things like arthritis, past operations to the same area, bone degeneration which i have, spinal scoliosis which i may have (you saw the x-ray), and other age pronounced things in us older people. if the "healing or healed" time frame is based solely on ALL people of all ages lumped into ONE category , wouldn't that be discriminatory?

In the end when you go in for IME expect it to already be in progress as you are in the waiting room. Sometimes starts if they get lucky and spot you from outside. Be truthful and if you are in pain tell them. Give brief answers and don't elaborate.
Word of advice with NCM, even though they are liasons and very easy to talk to, they are bound by the same employer who is paying your work comp bills and therefore anything you say can and will be used against you. The IME has nothing to do with improving your pain/treatment, that's your doctors responsibility.
Don't fall for the I love you but I'm not IN love with you trap.

I told my lawyer MANY things yesterday, i told him that i know what is said here stays here. he reminded me, that is true, but be VERY careful of what YOU SAY to the ncm, the therapy people even the state run p/t place. even a seemingly innocent comment, can be your doom.

told him, yeah, i know, i don't get too chitty-chatty with those outside these lead/kryptonic walls here in your conference room.

he laughed, we shook hands, wished each other a happy new year. all of our time yesterday took under 30 minutes. Domino's would probably want to hire me as a driver.....

 

[pro1driver]

UPDATE

Monday of last week, (Jan 5th) was my last (for now) p/t session. The guy there that does the calling for more sessions told me he does not know if i would get anymore. The p/t gal said she will try to ask for 4 more sessions. I ain't heard from them since last Monday, so I called this morning. Guy said that he ain't heard from the insurance company. A few minutes later, he calls me to come in for Thursday, as he was told by the insurance company, they will call him back inside of 48 hours to let him know if I get more sessions.

I still go in February for the IME as well. Whatever, more p/t or no more p/t, or maybe the insurance company will send me to my state workman's comp p/t place, on the state's dime, who knows.

 

[Dockworker]

UPDATE

Monday of last week, (Jan 5th) was my last (for now) p/t session. The guy there that does the calling for more sessions told me he does not know if i would get anymore. The p/t gal said she will try to ask for 4 more sessions. I ain't heard from them since last Monday, so I called this morning. Guy said that he ain't heard from the insurance company. A few minutes later, he calls me to come in for Thursday, as he was told by the insurance company, they will call him back inside of 48 hours to let him know if I get more sessions.

I still go in February for the IME as well. Whatever, more p/t or no more p/t, or maybe the insurance company will send me to my state workman's comp p/t place, on the state's dime, who knows.

How are you feeling overall? Still no improvement?
IMO, You have got to have one of the most complicated healing process ever.

Looks like they are tossing a day or two at a time, to time it with your doctors appointment.
Being in therapy and doing stretches etc regardless if your healing, is better than not going to therapy, sitting at home and probably not doing the stretches under a watchful PT eye. Plus having too many off days between therapy sessions while healing is more painful than helpful, you end up stiffer and sore and people tend to toss more medication at it.

I think I remember saying a back fusion was given 32-34 PT sessions. (Give or take)
If those sessions did not bring you back to the level of strength your work requires, you would most likely be put into a work conditioning/work hardening program.
However, it would have to be approved by the Insurance company and probably require a FCE (Functional Capacity Exam) to prove it is necessary.

In your case, from what's been going on before your next update, your healing process has stalled. You have got to see your doctor to find out what road to take next.
Hopefully while things are getting sorted you are not healing improperly. Keep up with those basics stretches that you've learned, try to walk more or you will become as stiff as a board or addicted to pain meds.

 

[pro1driver]

How are you feeling overall? Still no improvement?
IMO, You have got to have one of the most complicated healing process ever.

Looks like they are tossing a day or two at a time, to time it with your doctors appointment.
Being in therapy and doing stretches etc regardless if your healing, is better than not going to therapy, sitting at home and probably not doing the stretches under a watchful PT eye. Plus having too many off days between therapy sessions while healing is more painful than helpful, you end up stiffer and sore and people tend to toss more medication at it.

I think I remember saying a back fusion was given 32-34 PT sessions. (Give or take)
If those sessions did not bring you back to the level of strength your work requires, you would most likely be put into a work conditioning/work hardening program.
However, it would have to be approved by the Insurance company and probably require a FCE (Functional Capacity Exam) to prove it is necessary.

In your case, from what's been going on before your next update, your healing process has stalled. You have got to see your doctor to find out what road to take next.
Hopefully while things are getting sorted you are not healing improperly. Keep up with those basics stretches that you've learned, try to walk more or you will become as stiff as a board or addicted to pain meds.

my next appointment with the surgeon is in March, after twice having my appointments cancelled by them. I was sick as a dog last week, was running a 102 fever. in fact, i had to take dad last monday to the doc. from there, i had to take him to hospital. he stayed about 4 days. he has the flu, even though he did get the flu shot. Well the day after, on tuesday, i had to go to the doctor, this is when they saw i had a 102 temp. while i was in the hospital with dad on monday night, i felt warmer than usual, and had a massive headache, but i discounted it as being there. so dad was in hospital, i was at home, homebound so much in fact i couldn't go and visit him and since i had no p/t and felt like crap, trust me, i didn't do anything at home for p/t myself. i laid there like a slug, more so worried about dad, as it was told to us he had an M.I. but was likened to angina, he had a heart attack back in 2006, nad has stents, and each time he goes into the hospital can be his last time coming home.

i get these annoying sinus infections, that if left untreated, or i do not self medicate fast, it blossoms into a full blown event, which knocks the life outta me. doc put me on antibiotic, and mucinex DM. in fact i feel a bit better, and later this morning have to take dad back to our doc for a check up, and he needs cough meds. he feels a bit better, they gave him that tamiflu stuff you see on the tv? 5 days worth, one pill a day. now mom has been sick, but she does not want to go to doc. so here i am, trying to get everyone better, and i ain't all that much better, coupled with my back, and other things that need to get done around here. too many other things to say, but you should get the gist of it.