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rheumatologist or orthopedist?

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Unread 04-28-2007, 12:37 PM   #1
momzpeachy
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Confused rheumatologist or orthopedist?

Hi all

i am trying to figure out which Doctor I should look at seeing next. I have been seeing a neurologist who diagnosed me with thoracic outlet syndrome and myofascial pain syndrome but I now have had 2 neurosurgeons look at me and my MRI and say otherwise. My MRI shows 2 herniated discs, one on the verge and osteophyte complex at C5-C6 with narrowing from C4-C6. Also have straigtening of the cervical lordosis. Also said to have cervical spondylosis. Ok, now the neurologist never mentioned any of that.

My mother has osteoarthritis and rheumatoid arthritis. Also her sister and her mother have it. it runs right down the family line. All with the same pain and problems. Now I am only 34 but also had a hysterectomy 3 years ago and since then been falling apart.

I now have pain in hte lower back and trouble walking. Of course no one has looked at my entire spine. just the cervical spine.

I'm currently not getting any treatment and i really dont' know where to go with this. I'm hoping some of you can make a recommendation and possiblypoint me in a direction.

Thanks for your help and support.
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momz of NE PA:
Right side TOS (Scalenectomy 1-14-08). Spinal problems. Thoracic Spine hernaited discs pressing on spinal cord and small tumor - still being investigated. A very tired mom who feels like giving up!

Wishing I could think more positive and be well again!
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Unread 04-29-2007, 01:59 AM   #2
Bobbi
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If it were me? I'd start with the rheumatologist.

My reasoning is: I don't know whether you've insurance or, if you, do: its protocols. For instance, to see a surgeon, my insurance "prefers" (for coverage) a referral be made from, i.e., primary care physician, rheumatologist, neurologist, etc.

If I were to see a surgeon, I'd select from a speciality you've not mentioned: A neurosurgeon.

My reasoning? Again, I promise I have some reasons . The main one is due to what you've noted about your C-spine and pain possibly from your L-spine. I'd want a surgeon whose focus is also on nerves - possible compression, radiculopathy, etc. - whereas ortho. is more centered on bones.

Either a neurosurgeon or an ortho. could be good; I merely mentioned what type of doc. I'd be wanting to see next... having been there, done that (with rheumatologist, neurologist, neurosurgeon and ortho surgeon).
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Unread 05-31-2007, 10:44 PM   #3
lailavia
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I'm having problems with my back too and currently seeing a rheumatologist who is now handling the back thing and a neurologist who is handling migraines and now arm fatigue. (I am also dx with fibro) I recently last winter just started with bad thigh pain and got mri of l spine and it shows some degenerative disk disease....minimal lumbar spondylosis....everything minimal......minimal...well it is now causing maximum pain and I have left a message with rheumy for getting set up for a shot. I had one relapse from the pain for about 3 weeks, right when I went to see him! Now its back with a vengeance, pain in thigh, when I drive, sit, moving to hip, lower back, starting to limp, my pain meds of ultracet , darvacet n 100 and zanaflex barely take the edge off and put me to sleep If I take the full dose. Is he sending me to a pain specialist? I am wondering If I should be referred to a neuosurgeon or spine specialist at this point??? Rheumy is saying its pinched nerves (sciatica) and will come and go....well help! You seem like you know a bit about this back stuff! I will ask the Neuro too> He is doing emg tests on my very fatigued arms next week from some freaky fatigue attack last fall. My bloodwork for Myasthenis Gravis and all kinds of muscle diseases is good. I just hurt all over! The ultracet used to take care of it all..
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Unread 06-02-2007, 01:04 AM   #4
Bobbi
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Yowsa... what a bummer... It doesn't make it easier, that's for sure, when pain decides to take a break on the date of an appointment. I wonder if your rheumy. would consider seeing you when the pain is at its worst; if there is a cancellation, and you call, possibly, he could see you during that time. I know that some of my most productive or beneficial appointments have been when I've been in pain; during the exams, it seems to give doctors more info. than when I see them and things are feeling semi-okay.

Pain, coupled with other health probs., can definitely lead to fatigue.

I'd take the referral(s) - to either/both a neurosurgeon and an ortho. surgeon.

Do you have a Pain Management doc?
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Unread 06-02-2007, 07:15 PM   #5
lailavia
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Default Got referred to pain specialist

Ok thanks Bobbi for the help....I finally called back and his ditzy but nice assistant hadn't even got my message and he called within the hour and wants me to go to a pyshiatrist/pain specialist who according to his "profile" also treats fibro. Then I noticed on web site there is a big new Spine Center just 5 minutes from here, and most of the docs are cerified anethesilogists (why is there not a spell check here? )and do all sorts of state of the art injections. Ultimately to avoid surgery. I don't know if my insurance will cover it, I have to go by referral, I don't see them in my referrall book, but they are new....I will call Monday...I am excited to finally be moving in some direction....I have 2 other appt. this week and always driving people around but this pain has got to goooo.........I wonder if I have ask rheumy if I can pick them over his pick....he is my main supporter for a current SSDI case? It seems like just cause Im in an HMO I should still have some say...they have to write out the dumb referrals.

Good luck to all!

Ohh, should I see what they say about whether to see the ortho or neruo surgeon? Or ask to see both?
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