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Is my PCP's protocol unusual
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Is my PCP's protocol unusual

For 3 months my PCP, an internist, has been seeing me for a cervical problem of no known origin that causes pins and needles and pain to radiate down my arms.  First it was the right arm and then it resolved as similar problems arose in the left arm.

The first month I was on flexeril and voltaren.  I was supposed to do neck exercises but I declined to do them without an MRI.

On my second visit, neurontin was prescribed and I was sent for physical therapy.  I told the doctor that I thought I should have an MRI before PT and he ignored the suffestion, but did so very politely.

3 weeks into PT, the therapist said he was going to see if my PCP could see me sooner than my shdeuled appointment a week and a half away.  The same day the therapist faxed my PCP a report suggesting the need for an MRI to rule out either DDD or a herniated disc.  My PCP got me in that afternoon.

At that time, my PCP said I had a choide of epidural steroid injections or surgery.  I elected to first go to pain management and am waiting to get in to see the doctor at the pain management clinic.  Meanwhile, my PCP has finallly sent me out for a cervical MRI and we are awaiting the radiology report.  Even without the report, I have a copy of the films and it appears that we will be talking about a rupture at C5-C6 that is right up against the cord.  C4-C5 is also pretty well into the spinal fluid but is not against the cord.  The axial at C5-C6 confirms the sagital. My reading of the films really isn't relevant to my question.

My question is this.  How could my PCP expect me to make a decision between pain care or surgery without the benefit of an MRI and possibly an EMG?  Would the better protocol have been to get the MRI and radiology report in order that I might make a more informed choice between ES injections and surgery.

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