Category: Paul

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.

Three outcomes from my January Hip Surgery:

1.  New left hip.
2.  New L4-5 annulus tear.
3.  End of my patient role relationship with anybody wielding a knife.

It now seems unlikely I will be  passing through the doors of a VA facility much ever again.  Maybe the occasional flu shot.  It is quite likely and my solemn intent, the next time a surgeon gets anywhere near me with a scalpel, will be too soon.

Study finds medical malpractice claims most often associated with orthopedic surgery.

They somehow managed to roll in all three top contenders on me:

Probably not the last word on this, but here’s the neurology wrap-up in a feedback survey returned to Front Range Orthopedics, at their request:

^{“Thanks for the update on how low back pain affects millions and there’s not much we can do about it. But I was only there about the L4-5 annulus tear. I understand how orthopedic surgery is the biggest malpractice generator in the business, so no need to cover for your buddies. Regardless, please document with the VA or Tricare, however that interface works, if at all, your specific diagnoses calling for conservative treatment only WRT the annulus tear. I will be following up in the coming weeks to ensure that communication is being properly conducted.”}

Then I find stuff like this.  Guess I’ll be on the quest for a 2nd opinion now…

…said the 20-something blue-jeans-clad office assistant, upon determining they did not have access to my imaging, rendering my appearance at the neurologists office yesterday morning moot.  Thanks for not wasting my money.  I think.  I was a bit surprised, since making a point to specifically ask about that, to which a VA staffer informed me “…sure, but they may want to do their own imaging.”  Apparently, a wasted appointment is needed to make that determination.  I bet they collect alot of copays that way.

What was all that nonsense I’ve been hearing about universal electronic healthcare records sharing?  Oh right – this is 2019 and the sharing part is still sneaker-net.  Oddly, a request for new imaging was denied, even with blanket insurance authorization and credit card in hand.  I’m taking bets on what the next obstacle blocking my quest for treatment will be.  I’m guessing their software will not read the CDROM handed to me by a VA staffer an hour later.  I’ve got to stop thinking it’s not possible to be jerked around any more than I already have been with this hip operation fiasco. 

It took waaaaay more time and effort to push this through the system than I’ve ever encountered before. The final tally was 2 IRIS complaints, 2 helpdesk complaints, 3 calls to the neurology scheduler, 3 calls to the nurses, confrontational appointments with a PA and 2 different orthopedic surgeons, and ultimately, a talk with Tom Martino on his radio talk show. I am dead fucking serious about all that. We could even include a couple of confrontational interactions with PT back in January-February if you want to go back that far. Not even mentioning the written communication. The last 3 paragraphs of a letter to Dr. Park are given below for your reading pleasure. I have no idea what one or combination of those things got this moving again, but here’s the latest entry from my symptoms log:

^{15 AUG 19: Managed to get an appointment with a spine doctor in Longmont next week. Been wondering how much worse PT made this from what they did to me back in Jan-Feb. It’s definitely getting worse, not better now. Rolling knots out of both glutes every night. Entire lower torso, hips and thighs in continuous, chronic strain. Any standing or walking causes increasing tightening in the erectors, glutes and obliques. Getting winded with minor exertion. Radiating ache from right side of L4-5 accompanied with sharp jabs on bending/twisting. Glutes are just about out of commission. Blood pressure still elevated – since January.}

^{The insomnia with this is different than earlier bouts, waking from pain or inability to fall asleep. Falling asleep is no problem. Lying prone is the only time the primary muscle tensing symptoms subside. Even just sitting is a bit uncomfortable. Then, if the dogs bark or I get up to pee at 4am, there’s no going back to sleep, because any meds are worn off and the dull ache from L4-5 I don’t notice much throughout the day becomes emergent.}

I clocked 180 over something the 2nd night in the hospital when they started withholding pain med, as usual. Of course I didn’t realize it at the time, but the burning sensation running up and down my spine had nothing to do with the new hip. That BP is just another clear symptom of the body’s auto-protect for an injury like this. Coming up on 8 months since they broke my back. Wonder if anybody besides Dr. Park has seen this letter sent to him in June, following the 1st formal complaint.

-snip –

Saw Dr. Brinkis, from the (now) 2-person surgical team, including Dr. Sylvestri as the current chief of ECHCS orthopedics and man who fixed my shoulder 3 years ago. Exactly what happened or why was not going to be discussed, except to say that Dr. Park no longer works there – not that he ever really did, as one of the contractors currently doing half the orthopedic surgery at the new hospital here.

As expected, apart from some tests, VA cannot accommodate any further treatment in a timely manner, so I’m being sent off into the civilian medical community to see a spine doctor. This was the last thing I needed, considering spinal issues already constituted the biggest problems in my disability situation. Now there’s a new problem there, and I just hope this new injury isn’t bad enough they need to go in and clean it up.

Still can’t believe I spent the last 6 months telling every VA staffer I encountered from the physical therapist, to the physician assistant to primary care to the surgeon himself, how badly I was doing in vivid detail, and every single one of them sent me away saying or implying there was nothing wrong with me. Perhaps disregarding Dr. Sluder’s April referral offer was unwise, but that was at the time I was still under the delusion of normality being instilled in me with comforting reassurances like “sometimes it just takes longer to get over an operation.” As it turns out, things eventually crystallize with an untreated back injury like this.

A little background before the upcoming appointment Friday with Dr. Park, the surgeon who performed my hip replacement back in January. Hopefully better light will be shed come Friday, subsequent to sacrum and lumbar MRI’s accomplished last week.

An unusual sensation emanated from the base of my spine accompanied by severe autonomous clenching and chronic muscle strain throughout my lower abdomen and thighs when I stopped the pain medication approximately 10 days after surgery. There were 2 problems associated with the surgery, the 1st of which is mostly resolved, with the 2nd remaining to be diagnosed.

Beginning in January 2018, I waited while the VA slowly and methodically slogged through one conservative treatment after another. Neurological and orthopedic exams, steroid injections and of course the months-long waiting periods in-between amounted to well over a year from the time I knew I had an end-state arthritic hip, to when I finally received the surgery. So the entire right side of my body compensated by developing an acute chronic strain condition. The right thigh in particular, became so deeply strained and sore I was often barely able to walk at all by the end of the day the first half of this year. Now after 6 months of misery, that problem has only just recently begun to show signs of remission. Within the past month or so, I have started using the cane more in my “right” hand, supporting the new left hip, which seems to be doing great, with only minor healing discomfort remaining.

Now for the bad part. I’m still grabbing the cane with my left hand due to: Either my lower abdomen was crushed like a bug with some sort of clamp on the operating table while my left leg was being sawed off and re-attached with a new hip joint, or the L4-5 annulus was torn tossing me around somewhere like a sack of potatoes. My first guess was a mashed-up sacrum. Dr. Park said it could be a stress fracture in my pelvis. L4-5 annulus tear seems to match the primary pain source from what I can decipher in the MRI reports. I was interpreting this as the worst of the muscle strain, but now it’s pretty obvious what is going on down there. Whatever it is, I’m effectively crippled.

It’s not just the VA, and could happen to anyone. I’m probably one of the lucky ones. Surgery is risky business. People make mistakes. Thankfully not a botched hip “replacement,” considering the new hip seems good so far. I’ll have questions to ask, and suggestions to offer regarding the patient clamping and handling procedure(s).

Had my left femoral ball upgraded to the titanium variety Tuesday morning. Hips are both prosthetic now. Procedure went smooth followed by 2 nights in the hospital. Once again, I cannot say enough good about the care I am receiving from the Rocky Mountain Regional VA. The new hospital in Aurora is just fabulous.