Category: Health

As expected, the Discogram was positive.  So, under my particular circumstances, we’ll open it up, clean out the mess, screw it back together with some metal pins, cross our fingers and wait a few more months.  Longest goddamn hip replacement EVER.  Here’s a little tutorial for those interested in more details about what I’m now facing.

And also as expected, my FOIA request(s) for information about the case turned up next to nothing, save one important exception.  Dr. Sylvestri responded to my initial complaint – just not to me – stating he saw nothing wrong.  I bet he doesn’t see much wrong with the gaps in VA healthcare that stole a year from my life (so far) and nobody seems to want to talk about, either.  They hurt me.  Bad.  Over a long period of time, and it’s not over yet.

Early on in this fiasco, my general perception of the way I was being treated suggested to my paranoid intuition, that I was being deliberately deceived.  It was just too blatantly unbelievable.  Turns out they are simply oblivious – right up and down the chain, including everyone in between.  Professional healthcare providers – oblivious to the suffering of one of their patients.  Now I’m not sure which is worse.  Maybe employee apathy isn’t real high on the radar.

I bet there are vets like me out there who might have given up.  I’m suicidal, for chrissakes!  Now I get it – the “VA thing,” that is.  So they do studies to try and figure it out, then give you a phone number to call.  Brilliant.  It’s not working.  My only question to the VA overlords might be:  Why was someone like me sitting here on a badly torn L4-5 annulus writing blog posts about it all year instead of going to the head of the line for whatever they needed the minute something like this crops up?  A satisfactory answer to that would be worth quite a bit to the next collateral damage victim.

The answer is right here, and I figured it out back in September.  Some things you can’t put a price on.   Epilogue coming in Chapter X – Formal Feedback – written down the way I used to give it face-to-face in the Air Force.  It’s not going to be pretty, but pretty much exactly how it appears in some of the AF records “I” wrote.

Dr. Donner will get to the bottom of my back injury in 8 days.  Latest from the Symptoms Log:

7 NOV 2019: Here’s the list:
Morning acute pain from swollen L4-5
Insomnia (from above)
Aberrant nerve signaling (muscle twitching, mostly right glute)
Muscle tightening/clenching when standing or walking (Glutes, erectors and right thigh) – with associated acute muscle pain if pushed more than around 10-20 minutes, depending on what I am doing
Muscle knotting in both glutes, right erectors and right shouler/back
Limp to the right
Ilial flaring badly/acutely
Entire right side of body lit up with the tension thing (I can actually feel in the right side of my head)

BP steadily on the rise for the past couple months – presently clocking around 150/90, but I think my own general anxiety level might be contributing to that. I have to remember to try it right after I wake up to go to bed one of these days.

It’s interesting to note how apologetic Rebecca was when telling me I’d be waiting a whole 2 weeks to get in for this.  The Aurora VA Neurology queue was 2 months, last I heard.

The weed horse has alot of life left in it. So I’ll keep aggressively beating it.  It’s not going away, and it certainly won’t die.  How do you un-beat the near-dead horse Christianity and Capitalism tried to kill?

I just realized personal corroboration for the NORML post linked above.  All through this back injury nonsense I’ve been confronted with doctors over and over again who didn’t seem to think there was anything wrong with me.  I wonder why…

There is no question Cannabis effectively calms the muscle spasms invoked by this particular back injury.  My entire midsection, down the right leg and up into the right shoulder were literally locked with muscle clenching throughout January and February this year, immediately following the left hip surgery.  At the time, it was just a bad reaction to the surgery.  Took 6 months of hacking through the thickest jungle of VA bullshit I’ve ever experienced to clear up that little misunderstanding.

It’s still terrible – I’m just growing accustomed to it.  Still rolling big knots out of my buttocks and back every night.  Still slightly limping to the right – with a fresh hip replacement on the left.  Go figure.  Like I told Chris the other day, I don’t care about the pain.  That’s no picnic either.  All I really want is to just be able to walk again.

Then that article popped up in my news feed this morning and I had an epiphany.  I remembered sitting in Annie’s office being interviewed at the Loveland VA a couple weeks ago.  It drew out late into the afternoon, and I was sitting there literally twitching from time-to-time because I hadn’t had any medication all day.  No – not the meth-head tweaker-type drug-withdrawal twitch.  It’s a unique little doodad this thing does when the glute receives some aberrant, momentary little jolt from the festering nerves in there that just sorta radiates out into the leg and up the back.  Left un-treated, it continues spreading further, more intensely, eventually clamping down and not releasing any time I’m on my feet.  It’s the body’s natural radiculopathy reaction to nerve root damage.  I wonder if Annie noticed me starting to do that, at the worst I’ve been in probably the last 2 months, or since my last T-break.  I’m pretty sure MJ is the biggest thing keeping me going right now.

But what about every other prior doctor visit so far this year?  They saw a healthy-looking 60-YO without a cane (most times) appearing to walk normally, good vitals – WTF?!  It’s easy to see how George was fooled.  I showed up at the first followup 2 weeks after surgery, off the hydrocodone already, rarin’ to go.  But I never recovered.  How much you wanna bet the Cannabis has been masking my symptoms all year long – enough to the point where doctors were slotting me into their personal whiny hypochondriac category right off the bat?

Just a theory.  But if that’s the answer to my VA problem, it’s still the wrong answer.  I’ve been telling them about it for years, turning down the pharmaceuticals.  KInda hard to get with the program when people can’t agree on how to conduct what program.

I was hoping to get this done in 10 installments.  After meeting with the folks at the Colorado Spine Institute today, that is finally starting to look like a real possibility.  Yesterday was also a stroke on the plus side for a change, when as expected, the EMG test turned up negative.  That’s a GOOD thing – still no nerve damage – or so they say.

CSI looks like the real deal.  I don’t doubt the last 2 spine guys are knowledgeable professionals.  But they aren’t good doctors, in my estimation.  The 1st guy had a canned spiel ready for me, and when specifically questioned about my 1 specific complaint, both of us gazing at the MRI display, his response was “what, that little thing – that’s nothing.”  The 2nd guy just flatly refused to do what I knew then needs done.  And just for the record, Dr. Knight with the rehab gang in the Aurora VA also flatly refused.  I haven’t even met Dr. Donner yet, but his PA, Chris took the time to ask all the right, carefully reasoned diagnostic questions, AND explain in detail the complicated mess of potential implications and outcomes.

So I’ll undergo a CT Discogram soon as we can get it scheduled, and see what happens.  Best guess prognosis at this time seems to lead to a fusion procedure.  Or it could be nothing, maybe something in-between.  I’m not exactly looking forward to another surgery, but I can’t go on like this.

 

There’s a couple of things about my current healthcare misadventure really bothering me.  One I understand, the other I do not.  I understand how the healthcare system is not set up to care for patients like me.  It is dealing with a big population of crybabies who cannot stop complaining after they stub their toe.  No biggie.  I get that.  What I do not understand is how torture became an acceptable course of diagnostics.

I’ve been left to rot, suffering with a painful, debilitating, un-treated back injury all year – forced through hip replacement rehab, where the biggest obstacle was not a freshly installed prosthesis.  Let them go until something happens or they scream loud enough to get someone’s attention?  Has it really gotten that bad?  Have the diags ballooned to such expense doctors are being discouraged from ordering them?  Must be, because I have this uncanny ability to know when I am hurt.  It’s called being a conscious human being.  That part is getting real old.

These things typically take a long time to heal – if they do at all.  The bad ones don’t.  This is a bad one.  Read the goddamn MRI report.  Still no medical attention as called out in said report, 9 months on – after seeing what, 7 doctors now?  I’m losing count.  Oh wait – not entirely true – I got a bottle of muscle relaxant pills from my new PC.  They do help a little.  But they are TOXIC, like most pharmaceuticals, and are only to be used for a max of 3 weeks.  It’s something, I suppose.

Read the goddamn Annular Tear lesson.  Dr. Mork is telling my story better than I can.  So, without enough time to read and just do your fucking jobs, the un-written policy appears to be, at least in part:  “Ensure diagnostic torture protocol and procedures are strictly adhered to whenever it starts looking like we screwed up.”

(Late Update:  as expected, after the new referral from last week didn’t show up, a call to the Loveland community desk or whatever they are calling it this year, found it in “status unknown” state.  I repeated all my information to the nice lady for the eleventy-seventh time while she set the wheels in motion.  Again.  And again, and again…)

Thinking back from the start of this fiasco, it all makes sense now – particularly the part where they start withholding pain med to help gauge your take-home prescription.  That is permanently seared into my memory.

It’s so easy to slip through the cracks.  I feel like I’ve been fighting a losing battle against the system all year and gotten to the point where just struggling through daily life and trying to deal with this at the same time has left  me so physically and mentally exhausted I’m ready to throw in the towel.  After seeing the KMS gatekeeper Dr. Knight Tuesday, we’ll do the EMG test, and see what they say about that.  I imagine it will be either inconclusive, or find some unrelated issue I don’t care about, like the carpal tunnel last time.  Guess what she said when I told her my pain was getting worse and definitely not chronic but acute?  “So this has been going on since January, huh – looks like it’s chronic now.”

Fortunately, the first real ray of hope since July came Thursday with Dr Thieman, my new PC out of Loveland.  I’m not a religious person, but by some miracle apparently, he was familiar with something at least similar to my issue and and is sending me to see a spine guy who might recognize it as well.

After the MRI finding was made back in June, I’d have let Brinkis get away with blaming it on me!  All he had to say was something like “…occasionally we see this in older patients with weakening structures due to disc degeneration, etc.  It’s not too serious, just takes a long time to heal, so now we need to…”  And that would have been the end of it.  This is starting to feel like an “innocent until proven guilty” proposition where nobody even wants to look at the evidence.  They are maintaining my toxic annular tear innocence at all cost.  Too bad I’m the one paying the bill.

Yeah, I definitely got crushed.  I’ll be going for a 3rd with my new PC next Thursday.

So the other Longmont spine doctor named Dr. Smith wanted to do some injections to isolate where the pain is coming from – after I told him.  Multiple times – along with a rehash of everything else for the umpteenth time.  I didn’t bother asking him to explain how making the pain go away with anesthetics and steroids would better help find it.  That just seemed a bit too insulting to both of us.  Ineffective and unnecessary diagnostics appear to be an important bottom-line booster.  Gerlach got x-rays.  This gentleman gets paid only for another useless office visit, despite trying to get more x-rays and some injections.  Seriously?  You could cut the diagnostically bereft dishonesty coming out of this guy’s mouth with a knife.

Seeing the overall healthcare picture from this perspective is disturbing.  It’s probably the biggest reason why I like the VA – they are certainly not in it for the money – but that engenders other issues.  In any event, apparently patients are not the best source of information about their maladies these days, regardless of who is writing their doctor’s paycheck.  My view of doctors is dimming at an alarming rate – probably normal for someone my age.  They are after all, just people.

And I have no problem with people making mistakes.  The problem comes when they don’t own up to it, followed by lies of deceit and omission.  This one particular mess of a therapeutic misadventure is now becoming clear.  They let little things slip from time-to-time.  Smith knows or at least knows of Park.  They also seem to know they have a problem, and it’s not my back injury.  Stalling probably works in most of these cases, just not this time.  This type of dishonesty appearing to be an acceptable course of action is stunning, to me.  How naive I must be.  Orthopedic surgery outcomes like this are a not uncommon occurrence, so they just try to ride it out, hoping the patient gets better?  How many more doctors do I need to tell I still haven’t recovered from the January surgery?  Next up:  MKS on the 1st.

Maybe I turn up with some morbid complication?  Depending on what turns up in other areas, they better hope I don’t need another surgery because of this.  If I find out they knew about it and were just trying to wait me out, I’m thinking max-dollar tort against the government.  That’s how it’s gonna go if we find some REAL bullshit going on.

The only thing I can prove right now is they knew about it for sure in June – if anybody was paying attention.  There’s strong indication in the record they should have known about it in January, right after the surgery.  Patients aren’t the only ones signing release forms.  Probably not even worth it after the state, feds, hospital and lawyers get their cut.  I’m sure there are legal time limits well-aligned with the delays.

The long slog through numerous failed attempts at getting my VA-Inflicted back injury treated was a foregone conclusion nobody was ever going to tell me about.  Of course my IRIS complaint inquiries were probably investigated, at least to some extent – none of the findings of which (if any) were ever communicated to me.  And thus the cover-up began in earnest at that time, with the following utterance:  “Dr. Park doesn’t work here anymore.”

Interesting.  I don’t recall ever asking if he did, or if I could see him again, because frankly it would have been a bit uncomfortable.  But that was the 1st thing Brinkis said to me as we walked into his exam room.  Scary to think, but it’s probably just a stock response to this sort of routine issue.  I kinda doubt suspected bad doctors just get fired and that’s the end of it.   Seems rather presumptuous to believe a stranger like me is really that stupid, but I guess that’s the preferred approach.   I was actually quite well impressed with Dr. Park, from what little interaction I had with him, and suspect the only thing he may be guilty of is inexperience.  Whether or not anyone actually knew or realized what happened to me that day became basically irrelevant once the systematic denial and mistreatment began shortly after the surgery.

So I’ll take a liberal tack and investigate the investigation starting with several FOIA requests.  I wonder if a smoking gun of malfeasance on my case turns up at the new Aurora VA facility.  What happened to me is incontrovertibly recorded in official VA medical records.  VA’s response to that information remains highly dubious.  Brinkis’ consult written for “lower back pain”  not “L4-5 annular tear”  was useless.  Under the circumstances, I presently believe everybody knows what the problem is – they just refuse to diagnose it, hoping I’ll get better and go away.  So referral to the outside providers was met with nothing but reference to chronic low back pain, despite my clear, detailed description of the symptoms not being chronic, with acute pain from that one, single spot.  All Gerlach did was improperly collect a co-pay and some x-ray fees, none of which was legitimate, because I don’t do copays, he did nothing, and the VA imaging I carried with me on a CD was higher resolution anyway.  He was just collecting money.

I’ll be trying to get a 2nd opinion with the bad consult on the 24th with a different spine doctor.  There will be no x-rays, or detailed diagnostic interview.  They will either order an L-4-5 discogram, or our visit will be quite awkward and brief.  Then, depending on that outcome, I will re-tell the whole story to a VA PT doctor once again on the 1st.  My new Primary Care Provider was initially scheduled for the 27th.  They got sick, then see below.  That would have happened yesterday, but they had to reschedule due to an administrative SNAFU.  For me at least, it’s gotten to a point with the VA, to where I just expect delay and screw-ups.  All I ever wanted was to know what happened and get my back fixed.  This is what I am dealing with in terms of VA scheduling:

I’m pretty sure somebody will eventually end up going in there to clean it up, because it’s in the 3rd or 4th different stage of whatever it’s doing and definitely getting worse – “festering” would be the layman’s term.  Only questions are how to find an interested Dr. and how much further damage ensues over this lengthy course of mistreatment.  Starting to look like all of 2019 is down the proverbial tubes for me.

(Late Update 09/19) Almost on cue, I got a call from the Loveland Clinic this afternoon to re-schedule yet again.  Story was, Denver input the PC change wrong.  So they re-scheduled the appointment with the wrong doctor last week, then fixed that yesterday and re-scheduled again – each time getting further away. LATE UPDATE 20231220: Upon review, I am now certainly convinced they knew exactly what was going on – just performing the cover-up.

I get so tired of doing other people’s work for them. But yesterday was progress.  Like I said in the last installment of this saga – probably not the last word.  I understand how listening to old folks complaining about their back problems could become de-sensitizing after awhile.  Sorry, but if you’re not ready to do that conscientiously with real concern, you might be in the wrong business.

Anyway, TriCare (insurance provider) is looking at a re-do or 2nd opinion on the spine eval, and I have a new Primary Care physician, based out of Loveland.  Evidently, this annular tear thing happens to be one of the least well-diagnosed back issues in all of neurology.  Just as I had to corner a surgeon and demand an MRI in June, it now appears I will need to perform a similar instructional session regarding the need for a CT discogram with yet another highly skilled and qualified doctor, suffering from their own hubris and diagnostic inflexibility.

I’ve been meaning to change my Primary Care location for years, but primary care has never been anything I was too concerned with.  They give me drugs I don’t need or want, listen to my healthy heart and lungs, and provide referrals.  I just need that last bit for someone to work on the mechanical and electrical issues.  In my case at least, the so-called “Primary Care” entity has never been anything but a time-consuming scheduling roadblock and source of confusion.

The 3rd thing from yesterday was the VA did manage to re-instate the MKS (physical therapy) consult without another office visit, so that’s something, I suppose.  I had to cancel that appointment last week to go see spine doctor Gerlach in Longmont.  When I called to re-schedule, they told me the consult itself was rescinded?  Deja vu.  Remember the original spine consult from back in July?  (Cue Twilight Zone soundtrack.)  Still a little nervous about submitting to PT without a diagnosis, but we’re on the 9-month mark with a painful, disabling, un-treated back injury at this point. 

Sooner or later I will figure out how to get someone to help me extinguish the fire burning my ass any time I’m on my feet more than 10 minutes.