What is a physiary apointment for?

What is a physiary apointment for?  I was in a car accident and my Lawyer has set this appointment up for me.  what should I expect?

[kimberdalez]

physiarty assessmet...sorry for typo

[kelsgor0422]

Physiatrists, or rehabilitation physicians, are medical doctors who are:

Experts at diagnosing and treating pain

Restore maximum function lost through injury, illness or disabling conditions

Treat the whole person, not just the problem area

Lead a team of medical professionals

Provide non-surgical treatments

Explain your medical problems and treatment plan

Work not only on treatment but also prevention

Rehabilitation physicians are nerve, muscle, and bone experts who treat injuries or illnesses that affect how you move. Rehabilitation physicians have completed training in the medical specialty physical medicine and rehabilitation.

I hope this helps. I work for one.

[kimberdalez]

Oh yes this has helped alot, It wasnt what I was thinking at all.  Im not sure exactly what I was thinking.  I am concerned that I will be crying through the whole appointment because it seems to be all I have done for the last few days.  I have just started to take time off work because of the pain and the life changes are a bit distressing

[opus88]

just a word of caution a physiatrist will also likely suggest you try nerve blocks, steroid injections and/or epidurals in conjuction with your therapy. do your homework and read up on all these procedures before agreeing, some have alot of success with while others have experienced an increase in pain. ask alot of questions on this forum and do some reading on these procedures...just type in the word on google as I did.
good luck

[kelsgor0422]

Yes, I would also agree with Opus88. My place of employment is very into doing injections on people. But, prior to this job, I had been a patient at 2 orthopedic practices who were doing injections on me also. I have had way too many in the past 3 years. Now my hormones are all out of whack. Too many injections can cause hormone issues and bone issues. I have had 1 epidural injection that worked for 4 months and I felt like a completely different person. Before this doctor could do another one......he quit my place of employment and they are sueing him. So, I am not able to go to his new practice and get another injection. There are all different kinds and ways they can be done. Please question or research. What kind of pain do you have? Have you had any surgeries?

[kimberdalez]

Thanks for the feed back i really appreciate it.  I have  disk buldges at c3-c4, c5-c6 c6-c7, T7-T8 and the one i am having surgury scheduled for is at l5-s1 and is posteriorly 1.5cm and inferior 1.2 cm reducing the thecal sac by 50%. The pain is worst in my legs and lower back.  The back feels like it will "fold" and is very weak and sends pain down the sciatic nerve. My left leg feels like it is going to give out all the time, my thighs ache so bad they feel bruised and my lower left leg actually feels inside like some one has hit me with a bat but the out side of the leg doesnt hurt.  the lower leg pain intensifies when I stand and the thigh pain intensifies if I sit for too long.  I have back spasms and my legs feel heavy and shaky.  My legs were twitching so bad when i lay down my neuro after doing nerve testing ( ouch) put me on gabapentin which has helped with the twitching.  I have had an allergic reaction to certain steroids before so I will have to watch if they suggest injections. I have seen a surgeon who says he will remove the large herniation but since i have had it for 4 years the chances of sucess decrease and he expects me to go from thsi lvl of pain to a lower one but that I will never be pain free...I had thought surgery would be a fix all I guess.  This all started after a minor car accident where I was rear ended.  I was hoping to find other options other then surgery but my appointment for the pain clinic isnt untill September..crazy long wait and I cant stay like this for that long,

[kelsgor0422]

September??? Wow! Where do you live? If you lived near me, I could get you in to my pain clinic next week.....because I work there. But, we aren't scheduled out that far. There is no way they can expect you to wait. Isn't gabapentin the same as neurontin? Neurontin made me feel like I had a bottomless pit and I couldn't quit eating. I have been looking and searching for a "FIX" for 4 years. No one can even figure out what is all causing my pain. That is very frustrating. At least, you have answers. I, also was trying to find other answers besides surgery. They wanted to do a spine fusion at L4-L5 and L5-S1. I won't do it. Some docs say yes and some say no. But, they have finally told me, I will never be 100% pain free. Even after the fusion, I could be in more pain than when I started. I am not willing to take that chance. Have you ever looked into a SCS? Not sure if you would qualify. But, it is used alot with people who have radiculopathy, which is what you have. That is the pain that runs down the leg. At least, with a SCS trial, you can see if it works for 3-5 days. If it does.......you get it implanted and no major surgeries are needed. You can remove it at anytime you choose. If it does not help, then you know you have tried everything and the last resort would be surgery. It might be worth looking into. If you have any questions about it, let me know. I can give you a few websites to look at that will explain it or I can explain it. They just started me on Savalla medication. I have tried cymbalta and lyrica. I am also headed to a holistic doctor monday. He is new in our area and affliated with one of our large hospitals. It can't hurt. I will try about anything right now. This life has to stop. I can feel your pain. Good luck and let me know if you have any questions about the SCS.

[kimberdalez]

I have never heard of SCS..Deffinatley intrested.  I really dont want surgery but at this point even if it brings the pain down a lvl or 2 Im almost ready to risk it.  I was wondering why i was finding myself infront of the fridge staring in constantly..it never occured to me that it might be the medication.  I though it was the depression trying to settle in.  Im trying really hard to just curl up in a ball and do nothing.  This computer and this site are a great tool for help, conversation and to keep my mind active.  Also knowing Im not alone with this pain is a great coping tool.

[Tuckamore]

SCS is a Spinal Cord Stimulator. It works well for some ppl. It's implanted and provides an electrical current in an attempt to "confuse" the pain signals that are sent to your brain. It's much more detailed than what I have written but that's the general jest of it. I think of it as an upgraded and more sophisticated TENS Unit. You are not alone. As you have found there are many of us with chronic pain. MH is a great forum to connect and share with others in the same or similar situation.

Kelsgor, Gabapentin and Neurontin are the same drug. The generic name is gabapentin and there are two brand names that I am aware of, Neurontin and Gabarone. I agree that it is a long wait. It seems there should be other options.

[kelsgor0422]

Thank you Tuckamore. I keep seeing people talk about Gabapentin and I thought maybe it was the same. A girl told my mom about Neurontin and how wonderful it worked for her. So, we aske the doctor and he wrote me a script. I quit within a month. I had quit smoking before that and started to put weight on. I could not afford to gain anymore from the medication. With the pain, weight gain, clothes not fitting.....the depression was getting worse. I can't be active because of my pain so I feel like a lump on a log. Several months ago, I had bloated up really bad. My friend is a nurse and she got really worried about me and took my blood pressure. But, it is always low. The bloating has went away and I have also stopped my cymbalta and lyrica. I would guess, one of my meds was causing it. I have since, lost a little bit of weight but I don't hardly eat anymore. I have no appetite, ecspecially when the pain is so bad. Everyone is preaching to me about not eating and how that is not helping my body or the situation. I just wish........they could be in my shoes for just 1 day.

Tuckamore is correct about the SCS. It is a sophisticated tens unit. Have you ever used a tens unit before? If you were interested in it, you must see a physcologist first. They have to make sure you understand what it is, find out what your expectations are, and make sure you are not suicidal. This is just he protocal to have the trial done. If you get clearance from the physcologist, then you go in for the trial implant. They can do this in the office procedure room. You are not put to sleep or anything like that. They will insert wires that are called "leads". Most people get "dual leads". They will insert a hollow needle type thing and feed the lead up each side of the spine. The leads look like a stereo wire but clear. On the wire, there are little, flat, metal pieces which are considered the "electrodes". You will then have a little remote control that is connected to the leads. You can set the control to different vibrations or pulses. This is to create a distraction on the nerve endings and help stop some of the pain. Your spine/vertabrae have nerve endings coming out of it, all the way down your back. Certain levels and nerves are associated with the pain that runs down your leg. This is how they know where to place the "leads". The trial period is for 3-5 days. You are unable to shower during this period. But, you can sponge bath. If it works and you like it during the trial period, they will remove the trial "leads" and schedule you for the permanent placement. When the permanent placement is done, it will be under sedation. They will put the same kind of "leads" back in your back and cut a little slit in your butt check. This is where the little battery pack will be placed. Then you are sewn up and you are all done. Depending on the company they use, battery packs will last anywhere from 5-9 years. The battery is about 2" wide and very thin. If at anytime in the 5-9 years you decide you do not want it in anymore, it is easily removed. This is the least evasive option prior to spine fusions or surgery. I hope this helps. If you have any questions, let me know. I am curious where you live since you can't get in until September. I am still amazed about that.

[kimberdalez]

Well had my appointment today.  Was told the same thing I have been told at most of my other appointments.  Have surgery ASAP. He has determinted I have nerve impingement which is causing muscle weakness.  I cant walk on my tip toes or heals apparently.  I live near Toronto and am told it is normal to wait usually 6 months to get in to pain clinics in and around the Toronto area. One DR says off work the other says keep active one says less meds one says more, One says physio the other says NO..All I know is I hurt and my mood is on a nasty down ward spin.

Thanks everyone for the ideas, I will ask my Dr at my appt next week about some of these things

[kelsgor0422]

Thank you for the update. But, sorry to hear about the results. Now that you state you live near Toronto.....no wonder you have to wait 6 months. I could not live in Canada. Pretty soon, I won't be able to live in the US if our government gets involved in our healthcare. I don't think anyone should have to wait that long. What are you supposed to do in the meantime for all the pain? Is the surgery supposed to fix everything and get rid of the pain? What kind of surgery.....spine fusion?

Good luck and keep us posted.

[kimberdalez]

The surgery I am having is discectomy laminectomy. I go back to see the surgeon on April 6th and i will then get the date for the proceedure.  Im scared. Im more scared that I wont wake up from the anisetic I think then the actual proceedure.  I have days when I think I wont go through with the surgery then i have trouble walking and the pain is overwhelming and I cant do what i used to enjoy then i think i HAVE to have this done to have my life back some what.  The pain makes me cranky and i hope that will settle down as well after the surgery but I hear mixed things from people.  Some say It gave them their life back and others say they still have back pain but the leg pain is better.  Guess im going to find out

[kelsgor0422]

Hello! I am actually excited for you. This is the same surgery I believe I need, but all the Drs I have seen are jumping straight to a spine fusion. I have been talking alot about the discectomy lately. I came to this conclusion after a recent visit to the hospital emergency room last week. Please do not be scared of the anesthetic. I have had 6 surgeries in my life and that is acutally my favorite part. I finally get some good rest with it. : ) A co-worker of mine, just told me about her husband getting this surgery done. She said he was back to work in 2 weeks and he does construction. She said, he wished he would have done it sooner and he felt soooooooo much better. I completely understand about the pain making you cranky. I can't even live with myself some days. Lol! I am wishing I was in your shoes and they told me that would work. I am waiting for a Dr to tell me that. I would be in surgery the next day, if possible with no hesitation. Please do not be afraid. Look at it as a positive and regaining your life back. Also, please keep us posted. I am so excited to hear how well you are doing after surgery. I will keep you in my prayers.