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Hey---guess what I have a 2 cm full-thickness tear in my left one of!Answer: the only functional supraspinatus I have left in my body!
I may have mentioned a biking accident I had several months ago. At that time I requested my attending physician to order an MRI considering my previous bad luck with rotator cuffs and impromptu dismounting of a bicycle. The doc wrote the order, but muttered that the insurance company might not approve payment. That led me to postpone the order to avoid being hosed by my insurer. To abbreviate the story, I then went to a physical medicine guy who was very helpful but told me to call him if the pain didn't go away after a few courses of prednisone. It didn't, so I did. And the scan he reordered showed exactly what I felt: torn supra with some other mild collateral damage. Not like my disaster 4 years ago, but a surgery-grade impairment.
Naturally I expressed great irritation for having to wait for the MRI until retraction of the tissues began (fortunately no muscle retraction, unlike previously). The doctor, a nice gentleman who nevertheless felt defensive about my ire (which was actually aimed at my primary, not him), told me that a 3-month wait-and-see approach to this type of injury was the "national standard of care" before an expensive test was ordered. I asked him where this "national standard of care" was codified, and he told me "nowhere." He said it's something that doctors learn as part of their practice.
Yeah, I bet. But I wonder who teaches them.
When a 57-year-old man walks in and tells a doctor that he's flown over his handlebars and deflected the fall with one arm and fast thinking, I'd think the "national standard of care" would be to exercise some fucking professional discretion and carry out a complete diagnosis.
I think what we have now in this country is a "national standard of don't-care."
c'mon, you didn't get treated any differently than a 57 yr. old man in Haiti or Somalia or Bangladesh would. What do you expect, some sissy French medicine?
ReplyDeleteHere's something else to consider. Why, exactly, does that test (MRI) have to be expensive? What does it cost to do one-- some electricity, maybe a lot, and ... what? I think the jacked up cost of the machine (bottom line for GE) serves as the excuse but amortizing an expense like that sounds like some corporate mumbo jumbo bullshit. How much of the expensive test goes into someone's pocket as a "profit" ought to be dragged out into the daylight.
RC....come to NC and go to Duke and see Dr. Alison Toth. Google her at Duke and look at her credentials. Ive League. She rebuilt my daughters knee.
ReplyDeleteI got lazy the past few years and went to a couple doctors locally in Raleigh, and I've had some really bad shitball doctors that make you wonder how these stupid fuckers got through med school, but in Durham (the City of Medicine) I've always had good docs. Live and learn, but Toth is the shit!
I will pick you up at RDU, take you to the hospital, take you out for some drinks, and send you home all fixed up.
Happy Thanksgiving!
Oil Can: well, I wouldn't exactly put it that way. But viewed in even the most benign way, this "national standard of care" led to a very inefficient use of medical resources. If the tear had been diagnosed immediately, a regime of immobilization combined with anti-inflammatories and steroids administered by ionophoresis might have promoted natural healing instead of waiting for retraction to begin and opening the possibility of further injury. I'm certain that the tear was significantly aggravated at least once during the past several months.
ReplyDelete59er: thanks for the tip. My healthcare here is split between two clinics for historic reasons. This is the second time the Champaign clinic has fallen failed to make a timely diagnosis. The Urbana medical center, where my previous surgeon works, did outstanding work for me last time. So I'm hoping I can schedule with the same surgeon again---no complaints whatsoever about this gentleman. However, maybe some day I'll accept the second half of your offer and show up at your rum shack on the Outer Banks for the follow-up treatment.