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Don't believe my MRI / Issue with Doctor

First and foremost, thank you in advance for reading and providing any feedback you may have. I will try to summarize as best as I can. Please do not respond for me to discuss with a doctor. I know that. I am trying to get feedback on similar experiences, situations, etc.
3 years ago, I had prolonged neck and back pain. I went to a local orthopedic office urgent care office and they suspected some sort of disc herniation or impingement. They provided me with a prednisone taper pack, some pain medicine and scheduled a Cervical MRI. Week or so goes by, have the MRI and a follow up with the spine surgeon. The MRI didn’t show any sort of disc herniation, but did show quite a bit of other stuff.
MRI Summarized for brevity: Impression- (34 y/o W,M in open upright MRI) Mild to moderate multilevel degenerative disc disease resulting in mild bilateral neural foraminal stenosis, most prominent at C6-7 Level. Multi-level, but individually summarized to include osteophyte complexes resulting in moderate narrowing at C5-C6 and stenosis. Met with the surgeon, put on a higher strength prednisone pack and offered a injection in the neck, which I declined as the higher Mg pack worked and I went 3 years with no issues.
Fast forward three years, I am setting on the couch and sneeze. Immediate shoulder, neck and upper back pain followed by numbness running from my neck down through my shoulders and into my arm lasting about 30 seconds. I say to myself “that was weird” but think nothing of it. Two days later I wake up with neck pain and can barely turn my head to the left. I initially liken it to sleeping on it wrong, until days later it is still there and is now into my shoulder. Foot note- 3 years later I have moved and am a bit further away from initial doc, so I go to another Orthopedic clinic closer to my work. I leave early one day and go to their urgent care clinic (all PAs no Physician). I bring paperwork from 3 years ago and explain situation. Again, they suspect cervical, put me on taper pack, pain meds, and a follow up appointment with their “spine doc”.
At this point my symptoms are progressively getting worse and not even c lose to comparable to 3 years ago. Much worse than three years ago. I am now experiencing significant radiculopathy down into the neck, shoulders, tricep, sides of forearms, palm of hands, and middle/ring finger. Waves of searing pain (both arms/hands but left worse). I have also been getting left ear pain and migraines every day. I also can turn just the right way, very hard to re-create, but will have a shock run down my spine like I was electrocuted. At this point I am miserable and I am sure the MRI will paint the picture. I go and have an MRI (lying down this time). Now I am traveling, several days away from my appointment and call the Radiologist office to send me the images and impression. They do and the impression this time is essentially, nothing wrong and everything is fine. At this point, I am shocked. I am in the middle of an airport terminal and wanted to break down and cry.
Here is where I start to question the new “spine doc” office. I go to their website and no patient portal? I then find a general email address where I want to send a heads up to the doctor about all of the above and want him to be prepared to discuss the difference between MRI one and two and tell me why such a huge difference. I immediately get an outlook kick back that the email address is not valid. (completely different than the long standing orthopedic clinic previous, but more to come on that). So stranded in an airport, I am stuck until next week.
I show up to the appointment, never meeting this doctor before and previously unable to get in touch with him before. He walks in completely young and smug, smile on his face, condescending attitude and says your MRI is fine (all of late 20’s and just hired on at the clinic two months before come to find out but I don’t let that persuade me). I try to tell him that I tried getting in touch to share the previous MRI to which he responds, “ Who knows you read that, could have been anybody” (a well known surgeon and Radiologist read it by the way). Well, I have the findings in hand and give it to him. He immediately opens up the new images and say’s “oh, well on second look there is some stenosis at C4/C5, it’s mild to moderate”. Then he says we’ll get you in for an injection and before I knew what to say he stood up and left the room. The nurse walked in and said someone would call me to schedule the injection. I was stunned. I left and got a call two days later from the Spine Clinic who they contract to do the shots. The other doctor 3 years ago by the way does everything in house with minimal wait. This new clinic advises the earliest they can get me in is two weeks later! Doogie Houser made it seem like it would be next day. I schedule anyway. I then send a prescription refill request in to the doctor considering this was not going to be quick as they eluded to. They do have this automated approach believe it or not. I waited about 36 hours and get a call. Foot note- It has now been 5-6 weeks since my first visit. The nurse says we got your refill request and we are unfortunately in the office 50 miles away from you today as they rotate. She says we called in the Flexeril, but the doctor “doesn’t do narcotics, but he will write for Tramadol if you are willing to drive an hour away”. At this point, my blood pressure is through the roof and I simply laughed and said no thanks. I asked her to send all of my records to my old doctor, I am now willing to travel as I am done with these people. I work high level in a Pharma company and to be told, “he doesn’t do narcotics” as if I am making this up like some druggie is beyond me. I am furious.
It has now been days, they have yet to transfer my files, but I will be on them next week as my symptoms are life and mood changing at this point. I sent the previous doctor a note in the patient portal to give him a heads up, but won’t schedule until they do so in order for them to have the full picture.
I am at my wits end folks! Has anyone had a false or poor Cervical MRI results? Thoughts? Suggestions?
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Comments

  • LizLiz Posts: 9,699
    hello jeff
    there are no medical professionals on this forum side of the site. therefore, no one is capable or permitted to provide any type of medical advice.
    this includes any analysis, interpretation, or advice based on any diagnostic test all responses can only be based on member's own experiences

    please click on link for information about spine-health
    welcome to spine-health

    Liz, 

    Veritas-Health Forum Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • MetalneckMetalneck The Island of Misfit toysPosts: 1,772
    Hey Jeff,

    Welcome to Spine-Health

    I have also experienced - many issues with conflicting reports - and physician recommendations - and varied degrees of "Practice Management"

    A couple of things I have learned ....
    You can take your neck to five different surgeons - and get five differing ways to "fix" the situation.
    You can have a Mri (or any imaging) read by 5 different radiologists - and get 5 differing reports.
    I won't even comment on practice management at this time.

    Unfortunately they (physicians) make strong recommendations (or not strong enough) - to us, that we are supposed to accept as the gospel.

    But it is still referred to as "Practicing Medicine". They have been "practicing" on me now for the past 11+ years.
    I wanna know that they are done with practice and have it down perfect. It's only my life in their hands ....

    You may be interested in my story - there are many reports and images in there for comparison - there is a link below.

    Regards,

    Bones

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  • I completely understand your frustration when it comes to trying to work with slow-to-no response at a surgeon's office. Every step of the way after my surgery, and before, really, I would call and send emails (to the numbers and addresses THEY provided me for service) only to end up waiting and waiting and still hearing nothing back. Whenever I contact this office now, I ask for the person or department I need then tell the office staff "don't transfer me, leave me on hold, I'll wait." I started off hating feeling like I was being a pest, but I got over it pretty quickly, it appears the only way to get anything done.
    If and when I need more help with my back issues, I will be researching new offices, I'm tired of everything being an anxious hassle where I'm going now.
    Hope you find the help you nedd, good luck!
  • If you are concerned about the accuracy of your MRI, I would make sure that your imaging was done on at least a 1.5T machine, and preferably a 3T machine. I'm not sure where you live, but out there in the hinterlands, I understand that they are still using machines that are less than 1.5T.

    You mention "a shock run down my spine" -- that's called l'Hermitte's sign, which is a sign of very serious spinal compression, which doesn't seem consistent with your imaging. I had l'Hermitte's sign before surgery, but I also had severe spinal compression at C6-C7.

    As to how you were treated, unfortunately welcome to medical care in America (I assume you are in the USA). As insurers cut reimbursements, doctors make up for it by seeing more patients, meaning less time with each patient and long waits for appointments. Plus, in my experience, there is a shortage of spine surgeons, so I think the issue is particularly acute in that area of medicine. Two suggestions. You might try to find a physiatrist, which is a medical doctor who specializes in physical medicine, rehabilitation, and pain medicine. These spine specialists focus on the body's musculoskeletal system, which includes bones, joints, muscles, ligaments, tendons, and nerves. In my experience, it is usually quicker to get in to see a physiatrist then a spine surgeon, they have more time to spend with you and, if you do need surgery, they can run interference to get you in with a surgeon.

    Before my cervical spine surgery, I worked with a physiatrist who was quite good at holding my hand and helping me sort through the options. By contrast, most of my surgical visits (I saw 5 before surgery) were rushed affairs and involved two hour waits in the waiting room. Additionally, you could try a cash practice -- i.e., you pay cash up front and if you have out of network benefits on your insurance, you can submit it to your insurer and get reimbursed a fraction of what you actually paid. Those surgeons, because they have opted out of the insurance system, have more time to spend with you, but you have to pay a lot. The going rate where I live is $500 for a consult, but one surgeon charged me $1,500 (!) for a consult. He did spend quite a bit of time with me, but I ended up not using him because I found him swarmy. But my $1,500, he spent about 45 minutes with me, which is highly unusual.

    Finally, there is quite a push away from prescribing narcotics and you are going to find it harder and harder to find someone to prescribe them.
    C6-C7 ACDF - January 20, 2016
    Shoulder surgery - August 2, 2016
    Interlaminar laminotomy, mesial facetectomy and foraminotomy bilateral at C5-C6 and unilateral left at C6-C7 and bilateral C6-C7 facet fusion - December 7, 2016

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