Author Topic: what do doctors really know?  (Read 1052 times)

Ron

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what do doctors really know?
« on: May 06, 2008, 12:17:16 pm »
Well som eof you know I have been in near constant pursuit of a doctor who can tell me what's wrong with me.  My primary Ortho says it's beyond him and i needed to go to a general surgeon who could really treat abdominal injuries so I went to a "expert" board certified, general surgeon with all kinds of credentials. He determined that I didn't have a hernia (we knew that) and said just to rest it (no PT or excercise) and it would be fine, oh, he didn't really know what a sports hernia was either (obviously keeping up on his practice ?). That was March..... OK, so ski season ended and I decided to rest, it's now 2 months later and not a whole lot better. So I went yesterday to see a real expert, one of the lead dr.s for the Rutgers univ. sports team with advanced experience with abdominal wall reconstruction and hernias and such, Sounds good? Hmm, it was almost an hour away, I waited 1.5 hours to see him, after 10 minutes I was told I don't have a hernia and if I stopped those "crazy sports" like skiing, i wouldn't have so many injuries (note: only the skiiers thumb was directly skiing related other than this although I have a history of groin pulls on this leg) No prognosis of what is currently wrong. OK, I lied, did you know that I tore a muscle? Hmm what was the clue? So he recommends I go back to PT and "see what happens". I should be better by the fall just in time to get ready for ski season, of course I laughed when he said this; I start July1 for the season. Hmmm?   what else? Oh, that's right, he moved on to the next patient and didn't write up a script for PT. I called back today and was told by his assitant that the doctor doesn't normally tell the PT groups what to do, she thought maybe I could go there and "ride a bike or something, maybe stretch"....... is it just me????

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jim-ratliff

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Re: what do doctors really know?
« Reply #1 on: May 06, 2008, 12:42:25 pm »
 ;D ;D ;D
I thought Gary had tried to tell you what was wrong with you many times, but that you INSISTED you were SANE.? ?;D

Not you, it's doctors. Many don't care, just as many don't know.? And sometimes the really good ones like to be selective for the unique and challenging (it's not as if people's health is involved, after all).? It was a revelation to me when I realized, after watching the Army doctors that made the rounds each day, that not all of them graduated at the top of their class.? Some clearly weren't even in the upper half.? Up until that point I had held doctors and truck drivers in pretty high regard.

Wonder if Lynn will chip is here with any of her insights regarding working with doctors?

What about working it backwards.? Can you get an eval from PT somewhere based on prescription from your non-specialist GP, and then ask them what doctor they would recommend, or even if they think that a doctor is necessary?? Alternately, do you know any doctors that are skiers?? Ask them who they would go to.? Doctors usually know who the good doctors in the area are, even if they are hesitant to recommend.

Re-read.? That's really sad that your primary ortho couldn't recommend who you should see.? Very Strange.? Will he write a script to P/T, or have you been that route already.
« Last Edit: May 06, 2008, 12:52:23 pm by jim-ratliff »
"If you're gonna play the game boy, ya gotta learn to play it right."

Ron

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Re: what do doctors really know?
« Reply #2 on: May 06, 2008, 01:03:43 pm »
Ok, I will answer in order

1- hmmm, not sane, that we know. All members of my family shoud be on some kind of medication

2- my primary doctor is very good. The problem is that there just aren't a lot of good sports oriented doctors around here unless you find someone in the city (NYC) I tried that route with my shoulder several years back but the doctors who treat the pro's couldn't really be bothered with you so although they would be awesome, there's little interest on their part.

3- My PT guy, Eric is awesome, he is a tri-athelete and is really up on his training, He doesn't get a lot of severe groin /ab injuries and so he doesn't see a lot of patients who have this to learn which doctors are best. keep in mind, this ain't colorado.

4- Do I need a doctor? I don't know, i would just like to know what I did and if there's something more that can be done. So far, in 3 doctors, not one has ordered any test. The last two checked me for hernia's and that's it. No tests for strenght or really anything else. The guy yesterday was turning my leg. it turned fine, the problem is it never hurt to turn that way, but he never asked, he never even asked what hurt now? He didn't ask when I have pain or where. Didn't ask what activities I normally do, didn't ask my usual excercise program or how often, didn't ask my goals or what i wanted...

5- Yes, this is my second round of PT. the 2nd doctor said I should not excercise at all and it would heal. Rememeber , he did no tests either.

I just want to know what's broken, torn, srtained pulled or maybe everything is fine and I'm nuts........

Glenn

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Re: what do doctors really know?
« Reply #3 on: May 07, 2008, 05:19:20 am »
Did anyone do an MRI? That's unreal that they can't figure out what's wrong. My wife works in the medical field as an Occupational Therapist. Sometimes, docs are really conservative, other times, they'll recomend opening you up without blinking an eye.

What kind of pain are you getting?

gregmerz

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Re: what do doctors really know?
« Reply #4 on: May 07, 2008, 06:32:09 am »
I was thinking the same as Glenn, I wonder what an MRI would discover...

Perry

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Re: what do doctors really know?
« Reply #5 on: May 11, 2008, 06:56:27 pm »
Ron,
As a family medicine MD I'll apologize for my colleagues.  It is unfortunate that sometimes physicians treat to the "norm" and don't accept that some people may legitimately want to live at a much higher level of fitness than the average American. The suggestion to go to your family doctor, see if he will recommend you to a good PT, and see if the PT can help discern what is going on or if there is an exercise program that would help correct the problem is a good one

That said, I would be curious to hear of your symptoms.  When does it hurt, how severe is the pain on a scale of 1-10, what is the location and quality of the pain, dull, burning, aching etc, does it start in the right lower abdomen and shoot into the groin for example, what exacerbates the pain, what makes it better, does it come a a particular time of day etc.  If you feel it is from an injury, what happened to the best that you can guess.  If you fell for example, how did you fall, how did you land etc.  Once you type out your detailed answer, do yourself a favor and print it out and take it with you to your next MD visit.  It may help a lot in sorting things out.  A good history is 75% of the work in discovering these things.

The MRI may or may not be helpful.  Most MD's would want to be sure the test could help sort things out before ordering this expensive test.  ie - do I need to know right now or will this self correct.  After all, most things tend to sort themselves out (sorry if I'm clueless about something that has been nagging for many months.)  MRI can be helpful in answering specific questions...ie) do you have an abdominal muscle strain...so if you get far enough that someone gets a theory of what is happening it is fair to ask the question, 'Would an MRI either prove or disprove that theory, would it help us in any way?  And if we get the MRI would it change anything we are going to do?  If it doesn't change what you are going to do, why get it?


Lastly, follow up with your MD.....get a follow up visit if you are not happy with the way things are progressing.  If you go, try what the MD says and it doesn't help and go back with the same problem, no change, there is a lot more incentive to push a different button to find the answer.  Unfortunately, we don't always figure things out on the first wack.....it is a "practice" of medicine.

I hope this helps,
Perry

I will try to check for you answer.  Usually Monday - Thursday is a blur, but I can check in on Friday.
« Last Edit: May 11, 2008, 07:07:24 pm by Perry »

midwif

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Re: what do doctors really know?
« Reply #6 on: May 11, 2008, 08:52:32 pm »
Ron,

That said, I would be curious to hear of your symptoms.  When does it hurt, how severe is the pain on a scale of 1-10, what is the location and quality of the pain, dull, burning, aching etc, does it start in the right lower abdomen and shoot into the groin for example, what exacerbates the pain, what makes it better, does it come a a particular time of day etc.  If you feel it is from an injury, what happened to the best that you can guess.  If you fell for example, how did you fall, how did you land etc.  Once you type out your detailed answer, do yourself a favor and print it out and take it with you to your next MD visit.  It may help a lot in sorting things out.  A good history is 75% of the work in discovering these things.

I hope this helps,
Perry


Excellent advice.

Lynn
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Ron

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Re: what do doctors really know?
« Reply #7 on: May 12, 2008, 09:20:30 am »
thanks and here's the answers

1- fell when skiing, a twisting fall. Inner thigh filled with blood. NOTE: I have history of groin pulls on this leg
2- hurts primarilly in along the ingunal ligament; from just inside the fold of the leg and abdomin, then shoots down into the pubic bone/joint. Some pain radiants from the pubic bone down the inner thigh. Pain also extends into the quad from the top of the hip/quad area
3- hurts almost constant. Laying down on back is most comfortable. More when walking, running is not possible. Sitting more than 1/2 hour causes cramping. I have started gentle leg stregthening along with core work. I can only do limited range situps.  Pain can range from mild discomfort, to shooting pain, burning and to strong dull aching. I ice or use heat every night. advil as well
4- I am starting rehab again (did for 2 months) to see if I helps.

jim-ratliff

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Re: what do doctors really know?
« Reply #8 on: May 12, 2008, 10:02:00 am »
Ron:

Playing doctor   ;D.

Can you walk on just your heels?  The real question is whether you can easily hold your toes up against the pressure of balancing on your heels.  Can you walk effectively on your tippy toes?  Can you stand on the edge of a stair with just your toes on the stair and hold yourself up? Again the question is muscle strength in the calf?  When walking, would others say your gait is normal?  When you step with your right foot forward, do you still have control of your foot or do the toes tend to slap down on the ground?

Doctor Jim.
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Glenn

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Re: what do doctors really know?
« Reply #9 on: May 12, 2008, 10:51:11 am »
I find it crazy that they can't figure out what's wrong. It sounds like you had a pretty serious injury and you're experiencing regular pain. It would drive me nuts if they said: "Well, try more therapy..."

Ron

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Re: what do doctors really know?
« Reply #10 on: May 12, 2008, 12:28:52 pm »
well we know there was a considerable tear so maybe it needs more time but i just wish i knew what tore and if there was something better to do. Jim? huh?

jim-ratliff

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Re: what do doctors really know?
« Reply #11 on: May 12, 2008, 01:04:49 pm »
Grasping at straws.

Two common tests for neurological involvement that are more obvious than the tap on the knee or ankle with the little rubber hammer.

1.? can you stand and maintain your balance with just the front half of your feet on the edge of a stair?? i.e. do you still have strong calves?
2.? when you walk can you still control your forefoot or does it "slap" down as you walk?? shin muscles

You had a bad tear and those take a long time to heal.? But the constant pain and cramping and pain outside the primary injury area could be because the primary muscle has shortened and is pulling muscles around it; or it could be that there was also some neurological damage that is causing the cramping and possibly phantom pain in the hip.?

Your overall description sounds somewhat like the problems I was having last summer, severe cramping in the groin muscle that i couldn't stretch out, and a bit of pain in the hip and radiating into the leg.? In my case, it was a minor muscle strain (not your major tear) and more significant neurological impairment from the same event.? The two things above were the simple tests for neurological impairment, because they evaluate nerves by testing the lower leg muscles well away from the damage site (and then that was justification for an MRI).
« Last Edit: May 12, 2008, 01:09:03 pm by jim-ratliff »
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Ron

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Re: what do doctors really know?
« Reply #12 on: May 12, 2008, 01:41:17 pm »
no neuro pain  the musclles that tore in december are the same ones that still hurt. 

Gary

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Re: what do doctors really know?
« Reply #13 on: May 12, 2008, 01:56:22 pm »
Jim...can you stand on one foot and scratch your Heine .....with the other foot....can you chew gum and blink each eye at the same time and then reverse it, can you catch golf tees with your nostrils....with your eyes closed?

Hey...I wanna play more of this game!!!!... >:D

We all feel for ya brother Ron...but hey....217 days to go....start kicking this thing in the butt...don't make us come out there, load you on a plane and take you to ABasin ......for .......2 weeks until all your pain is gone.? ::) hmmm, I think I may have found the perfect cure!? ;D

Come on gang....let's go to New Jersey...it's intervention time!

Best,
Gary

midwif

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Re: what do doctors really know?
« Reply #14 on: May 12, 2008, 03:23:58 pm »
You are both wrong. 248 days to RSIII.
"Play it Sam"