Does my husband have a case?

[Luckydog62]

]What is the name of your state? NY

My husband is 44 years old. In July of 2006, while at work My husband got severely injured ,In the beginning he was having major discomfort in his legs. To make a long story short three weeks later he was in an urgent care facility because he could no longer deal with the discomfort and had started losing bodily function control. The next day ,he was having a MRI preformed, After the MRI he was scheduled to see an orthopedic DR.
HE went to the Drs appt and at that point was told he was being admitted to the hospital STAT This was at closing time in the DRS. office. They had fit my husband in because of the severity of his injury,. We left the Drs office with MRIS and Xrays in hand because this Dr was unable to preform the surgery because of insurance approval for him, not yet granted,but had been applied for. So there fore he had contacted a different Dr that accepted our insurance who would be doing the surgery. We submitted the envelope containg xras and MRIS upon arrival. The next morning The new Dr arrived in the hospital room stated he had look at the films and would be preforming the surgery the next day. The next day my husband had a Anterior Cervical Dissectomy ,corpectomy and fusion levels C5-7 . He was told that without the surgery he would inevitably become a quadraplegic. The Dr said he could stop any further damage from being done , but he couldnt guarantee my husbands condition would improve, We accepted that.We had no choice after all this was the second Dr to look at the films .Many interns examined my husband So we figured they had also looked at the MRIS and Xrays.. Since surgery, my husband has developed uncontrollabe tremors which they say are to do with spasticity, he still has discomfort in his groin and legs which was the original complaint to begin with.After nine months and four Drs ,My husband and I decided to look at the xrays and MRIS to see if we could pick anything different out , after all we know exactly where he has the discomfort, Which is when we noticed that the xrays that we had had that we retreived from the DRS office for a medical appt, contained not only my husbands films but also 2 other gentlemans films as well..These xrays showed a hip or shoulder surgery with screws and harware (stints) in my places that my husband has nevere had surgery. So my Question is ,Do you believe That any of the four Drs he went with these filme really looked at them. He went to three Orthopedic Drs and One neurologist. so far.. I do believe that my husband needed the cervical surgery as some of his symptoms have subsided. the issue is now they are having a problem figuring out what is causing the tremors and myoclonus, which is bilateral.. Help what do we do? Is this NORMAL?

 

[lealea1005]

]What is the name of your state? NY

My husband is 44 years old. In July of 2006, while at work My husband got severely injured ,In the beginning he was having major discomfort in his legs. To make a long story short three weeks later he was in an urgent care facility because he could no longer deal with the discomfort and had started losing bodily function control. The next day ,he was having a MRI preformed, After the MRI he was scheduled to see an orthopedic DR.
HE went to the Drs appt and at that point was told he was being admitted to the hospital STAT This was at closing time in the DRS. office. They had fit my husband in because of the severity of his injury,. We left the Drs office with MRIS and Xrays in hand because this Dr was unable to preform the surgery because of insurance approval for him, not yet granted,but had been applied for. So there fore he had contacted a different Dr that accepted our insurance who would be doing the surgery. We submitted the envelope containg xras and MRIS upon arrival. The next morning The new Dr arrived in the hospital room stated he had look at the films and would be preforming the surgery the next day. The next day my husband had a Anterior Cervical Dissectomy ,corpectomy and fusion levels C5-7 . He was told that without the surgery he would inevitably become a quadraplegic. The Dr said he could stop any further damage from being done , but he couldnt guarantee my husbands condition would improve, We accepted that.We had no choice after all this was the second Dr to look at the films .Many interns examined my husband So we figured they had also looked at the MRIS and Xrays.. Since surgery, my husband has developed uncontrollabe tremors which they say are to do with spasticity, he still has discomfort in his groin and legs which was the original complaint to begin with.After nine months and four Drs ,My husband and I decided to look at the xrays and MRIS to see if we could pick anything different out , after all we know exactly where he has the discomfort, Which is when we noticed that the xrays that we had had that we retreived from the DRS office for a medical appt, contained not only my husbands films but also 2 other gentlemans films as well..These xrays showed a hip or shoulder surgery with screws and harware (stints) in my places that my husband has nevere had surgery. So my Question is ,Do you believe That any of the four Drs he went with these filme really looked at them. He went to three Orthopedic Drs and One neurologist. so far.. I do believe that my husband needed the cervical surgery as some of his symptoms have subsided. the issue is now they are having a problem figuring out what is causing the tremors and myoclonus, which is bilateral.. Help what do we do? Is this NORMAL?

Your husband's surgeon informed both of you he could not guarantee your husband's condition would improve. I'm happy to hear some of his original symptoms have subsided and hope he continues to improve.

Obviously, the radiology filing clerks were sloppy. It does not mean the surgeons did not examine your husband's films. Did you immediately report the additional films and return them?

I'm sure you've discussed your concerns with his surgeon. What did he have to say about your husband's tremors?

 

[Luckydog62]

The surgery was done in August of 06..At that time we didnot realize the files were in the envelope . Actually the first time we saw them was last week. when we we trying to see if we could see anything the drs had not noticed. When my husband went to his surgeon various times over the last nine months the surgeon does not know the etiology of my husbands symptoms he said he did not think that it was connected to my husbands spinal injury, but of some unknown origin then in November he had the nerve to say my husband had never mentioned his groin and leg before which had been thhe complaint from day one.. urgent care told him his neck was damaged, he was not aware he knew his legs and groin felt major discomfort so therefore i know this surgeon did not look at the films. at this time the dr has sent my husband out to pasture he will be rerurning him to work next month because the neck is healing ..and has forwarded him to another ortho who stated that obviously this was nerve damage. and was the first dr crazy for considering sending him back to work considering the line of work he does. driving tractor treailer , moviing heavy equipment ,loading and unloading etc.. The new Dr has scheduled a appt with a nother neurologist.. because the first one never even bothered with a nerve conduction study. and the neuro says my husband is depressed and needs meds for that...
He is not depressed.. I know my husband.. he is frustated.. nine months.. no results..except now his neck is also uncomfortablein the process my husbands employer after eight months dsropped our medical insurance due to termination of his job in ten days time.. He had also been waiting for answers . My husband has none ..this all seems so surreal. tremors----stimulated by many forces sometimes stretching sometimes while dr examines pateller area for reflex which provoked clonus type movements and tremors.sensation increased to t1 vibration is diminished in both lower extremities.reflexes increased in upper extemities sustained clonus with myoclonic episodes normal mri of the brain normal eeg----- whats next i dont know I am not sure if his original issue has been dealt with . I sure hope more damage is not being done to my husbands body because of this delay in time..The neuro appt is next week .I wish it would come sooner. This has been a very long ride..I want off. Thanks for listening

 

[lealea1005]

The surgery was done in August of 06..At that time we didnot realize the files were in the envelope . Actually the first time we saw them was last week. when we we trying to see if we could see anything the drs had not noticed. When my husband went to his surgeon various times over the last nine months the surgeon does not know the etiology of my husbands symptoms he said he did not think that it was connected to my husbands spinal injury, but of some unknown origin then in November he had the nerve to say my husband had never mentioned his groin and leg before which had been thhe complaint from day one.. urgent care told him his neck was damaged, he was not aware he knew his legs and groin felt major discomfort so therefore i know this surgeon did not look at the films. at this time the dr has sent my husband out to pasture he will be rerurning him to work next month because the neck is healing ..and has forwarded him to another ortho who stated that obviously this was nerve damage. and was the first dr crazy for considering sending him back to work considering the line of work he does. driving tractor treailer , moviing heavy equipment ,loading and unloading etc.. The new Dr has scheduled a appt with a nother neurologist.. because the first one never even bothered with a nerve conduction study. and the neuro says my husband is depressed and needs meds for that...
He is not depressed.. I know my husband.. he is frustated.. nine months.. no results..except now his neck is also uncomfortablein the process my husbands employer after eight months dsropped our medical insurance due to termination of his job in ten days time.. He had also been waiting for answers . My husband has none ..this all seems so surreal. tremors----stimulated by many forces sometimes stretching sometimes while dr examines pateller area for reflex which provoked clonus type movements and tremors.sensation increased to t1 vibration is diminished in both lower extremities.reflexes increased in upper extemities sustained clonus with myoclonic episodes normal mri of the brain normal eeg----- whats next i dont know I am not sure if his original issue has been dealt with . I sure hope more damage is not being done to my husbands body because of this delay in time..The neuro appt is next week .I wish it would come sooner. This has been a very long ride..I want off. Thanks for listening

Perhaps other members of the forum can offer advice, especially given the additional information you've provided. Ellencee or Panzertanker out there?

 

[Luckydog62]

more info

Iam very sure that the xrays were mixed together at the second drs oofice before the surgeon had them.. i have an issue with the surgeon not looking at them before surgery as i know he didnt like i slike i said they were someone elses and besides my husband doesnt havescrews and hardware in his hip. so ther for e i assume he judt took the first drs word for it and never evaluated this himself ..is this normal?

 

[ellencee]

With an injury of this severity, it is normal to have some issues associated with spinal cord compression/damage.

What you, the OP, are describing as myoclonic tremors and pain in the thighs and groin area is the direct result of the injury to the spinal cord when it was being compressed by the C5-7 disc. My concern is that your husband receive on-going evaluation of his spinal cord to rule out any new compression due to the injury or due to inflammation and swelling of the spinal cord. If new compression is ruled out, perhaps a medication to control nerve pain would be beneficial. Elavil or Neurontin should provide some relief. Certain seizure meds are also appropriate for nerve pain. Your husband should discuss his treatment options with his MD.

I'm enjoyed a good chuckle when I read your concern over the additional x-ray films that were not your husband's.

The docs weren't surprised to see a filing error. They probably stopped and reviewed your husband's history to make sure he didn't have those injuries/surgeries and then moved on to studying the correct films. If the x-rays had been of someone's injured C5-7, then it may have been a real concern if treatment would have been done differently based on having the correct films.

You, however, should have returned those x-rays--like about 9 months ago. Get busy!

I hope your husband has a worker's comp attorney who will be able to obtain an open settlement to cover future medical needs and, or loss of income.

Best wishes,
EC

 

[Luckydog62]

From an MRI dated January 31st 2007 No mass abnormal signal, or abnormal contrast enhancement is seen within the cervical spinal cord. At the C3-C4 intervertebral level there is an annular bulge with impingment on the thecal sac but no impingment on the spinal cord. There is moderate narrowing of the right neural foramen and mild narrowing of the left neural foramen from uncinate process spurs with impingement on the right nerve root in the region of the neural foramen.C4-C5 level as the same as 3-4
C5-C6 mild tro moderate narrowing of the left neural foramen with borderline impingment on the nerve root o the left neural foramen
C6-C7 mild spina;l canal stenosis secondary to posterior vertebral bdy osteophyte formation with borderlone spinal canal impingment impingment on nerve roots in the region of the neural foramen at this level..Impession.... there are disc abnormalities and neural foraminal narrowing at several of the intervertebral levels this was the cervical mri ...impessionon the groin mri is mild non specific diffuse increased T2 signal intensity surrounding the right rectus femoris muscle extending into the femoral triangle and canal. I dont mean to be a pain but you have given us so much more information in 16 hours than I have been able to acquire in all this time ..Finally some sensible answers Thank you so much! Have a Great Day!

 

[Luckydog62]

EllenCEE More information added to former post

Please reveiw and tell me what you think.I would appreciate it. Thanks

 

[ellencee]

Please reveiw and tell me what you think.I would appreciate it. Thanks

The MRI report from January 2007 is consistent with the problems your husband is having. The nerve roots are being impindged upon, being crowded, compressed. It needs to be corrected or managed in some way to relieve the crowding. I don't know if medications, physical therapy, neck brace, traction, or an invasive procedure is needed. I do know some measure of treatment should be in place and regular monitoring of these areas is indicated.

I'll find you an article that explains how a C level spinal cord, nerve root compression causes pain in the thigh(s) and groin. It will be later this evening, though.

If someone else wants to find an article and post it--like, lealea or panzertanker, please do.

Don't let a workers comp claim become as damaging as medical malpractice could be. Stay on top of it.

EC

 

[ecmst12]

I'd like to see that article too EC, sounds interesting. I was wondering how the thigh/groin pain could be related to his neck.

 

[ellencee]

So far, the only article I found that explains the whole mess is a copyrighted article by a Dr.A and the article is written for medical students not laypersons. There are a lot of articles about acute cervical spine injury; but, I'm not looking for acute injury information.

I think it will help if the original poster can tell me the findings from the MRIs before surgery in '06; then, I can explain it with documented information.

If you're willing to take my word, I can explain it now. The spinal cord was distressed at the time of the injury, to the point that the surgeon stated the patient would be a quadraplegic and that means arms and legs would lose normal function. The surgeon also stated he could not undo the damage that had already happened; that translates into permanent damage has been done to the spinal cord below the level of injury.

If you are thinking in terms of referred pain, then you would only expect shoulder, arm, and wrist pain; but, you would be overlooking the most important aspect. The most important aspect is the damage below the level of the injury and that damage was caused by the spinal cord's being inflamed, irritated, deprived of normal signal conduction, etc. before the pressure was relieved by the surgery.

Now, the man has a very irritated spinal cord; one that is not receiving and sending signals as it should. One that not properly communicating with the nerves at the level of the thighs as demonstrated in the MRI findings of increased T2 signal. The increased T2 signal probably indicates fluid collection at that level, which is caused by the lack of normal nerve conduction to the circulations (blood and lymph).

The goal is to maintain current level of functioning while improving (decreasing) symptomology.

The question is: can it be done and if so, how?

I'll resume article searching later today. In the meantime, I hope that explanation helps.

EC

 

[ecmst12]

So the difference would be that this was an injury to the spinal cord itself, not only to the nerve roots branching out of it? That does make sense to me. The injuries that I see in the reports I review are just to the nerve roots (disc compression/herniation) and not to the cord itself, I haven't yet seen a spinal cord injury. Thanks for the info

 

[ellencee]

So the difference would be that this was an injury to the spinal cord itself, not only to the nerve roots branching out of it? That does make sense to me. The injuries that I see in the reports I review are just to the nerve roots (disc compression/herniation) and not to the cord itself, I haven't yet seen a spinal cord injury. Thanks for the info

When you are reviewing reports on nerve root compression, keep in mind that, over time, compressing the nerve root(s) can irritate/inflame the whole spinal canal/spinal cord "system" and other complaints may be directly related to the compression of the nerve root(s).

EC

 

[Luckydog62]

MRIS Dated 8/23/06

MRI Thoracic Spine
History arasthesias
PROCTOCOL Following images series obtained through the cervical spine: Sagittal T1,T2, And FASTIR Axial2 and GRE 3D
FINDINGS There is moderately advanced degenerative disc disease C5-C6.
There is a fairly broad based posterior C5- C6 herniation measuring 4.6 mm in AP dimension, 1.5 cm in transverse dimension and 9 mm in cranial caudial dimension.. the herniated disc is markedly narrowing the spinal canal narrowing. the AP diameter of the spinal canal to 5mm resulting in significant amount of cord compression.

There is a moderate degenerative disc disease C6-C7 with mild broad based posterior concentric bulging of the invertebral disc with the associated osteophytic spurring moderately narrowing the spinal canal but not causing cord compression . There
is still a thin rim of CSF fluid surrounding the cord at this level. there is mild degenerative
disc disease C3-C4 with a minimal degree of spinal cord narrowing but there is ample CSF space surrounding the cerviclal spinal cord at both levels and there is no acute focal disc herniation. no fracture. There is degenerative neural foraminal narrowing noted bilaterally C4-C5 , C5-C6, C6-C7.

IMPRESSION
1. Moderately advanced degenerative disc disease C5-C6. there is a large broad based posterior disc herniation markedly narrowing the AP diameter of the spinal canal to 5mm resulting in marked cord compression.
2. Moderate degenerative disc disease C6-C7 with mild broad based posterior concentric bulging of the disc with mild asociated osteophytic spurring narrowing the spinal canal but not causing stenosis..
3. Mild degenerative disc disease C3-C-4 with spinal canal narrowing
A STAT preliminary report was sent to the attending DR..
I have a copy of the original MRI on CD if you would be interested in looking at it..
I also want to say that I want to THANK YOU so much for all the time you have put into this
and for the answers you have given us.. I also wanted to add that one of the screws in my husbands metal plate that is at site of fusion three screws are in at 90 degree angles and the last upper screw is at a 40 degree angle . Would this contribute to any of the symptoms my husband is having..there is so much to this ..If you want to know all of it ELLENCEE please dont hesitate to E mail me and we can trade info. I am very impressed with the information you have provided. WE saw his NECK surgeon on February 13 and none of this was mentioned to us. rthen a different ORTHO who started to fill us in a little.You have been the most help BY FAR ..thank You Again I will try to be on at 7:00 and 9:00 this evening eastern time IF I dont hear from you then I will keep trying .IT appears like 12:30 is a good time during the day.. Hope to touch base soon..I also havea copy of the report of the mri of the thoracic spine dated 8/23/06 if you are interested i can copy and send to you Let me know if you would like any more info...

 

[ellencee]

You may send any information you want me to review. We can take this off the forum, but I'll defer first to the forum, second to ecmst, then to any other reader who wants us to keep it here.

ellencee@carolina.rr.com

The 50 and 60mph winds have left us with a lot of damage and we have been without power most of today and without telephone, cable, or internet. They've set up a few large generators, so until the generators fail I'll be able to communicate. I'm hoping the power is on soon but they've said it could be tomorrow afternoon! Oh, well...at least it's not cold!

EC