What Kind of Doctor Do we need to look for?

[bean29]

DD was rear ended in Mid-October. She has been seeing a chiropractor, but it is not helping.

She says she is in such bad pain that she skipped 2/3 classes on Tuesday b/c she did not think she could sit through an hour of class.  DD asked our Family Practitoner Dr. for a referral to a different Dr., but they have not responded.  Part of the problem is the Dr. she was seeing has left the practice and will not be replaced until Spring. 

So is she looking to schedule an appointment with an Internal Medicine Dr?  she is asking me if she should see a back and spine surgeon, but  I would think this is too early stage to be consulting a back surgeon - I hope that is not what she needs.

She was referred for PT by the Dr. from Home, but they send her to their affiliated clinic, which tried to schedule appts 6 weeks out - she told them she could not schedule out that far, they said they had to  - she said she did not reschedule/cancel the last few appts but she did not show up either.  DD goes to a local college, works in Janesville.  Home is 50 miles from the College and Madison is about 30.  We are thinking if she needs more PT she should schedule it in Janesville.  If she needs a Dr., I would think one from Milwaukee or Madison, but she called me and asked what kind of Dr she should be looking for and IDK what to tell her.

I was seeing the same Dr. she was, my prior one is retired, so I have no other Dr.  to consult.  DH sees a GP but I don't trust her with this.  Our insurance will let us consult a specialist w/o a referral I am pretty sure.

[NomoreDramaQ1015]

Dr. Google says look for an orthopedic doctor

www7.aaos.org/member/directory/definition.htm

[GRG a/k/a goldenrulegirl]

DH -- a healthy, fit, active 56 year old--has had 2 neurosurgeries in 6 years for a ruptured disk and is currently getting PT and injections for related issues, so I have a little experience in this area. It sounds like your DD needs some imaging done -- an MRI or Catscan to see what is causing the pain. Chiropractors CAN be helpful, but if there is something wrong structurally, you might need to see a specialty M.D. Usually primary care docs order that type of testing. Call the practice her primary care doc just left and get her in to see another doc in the practice who can order the imaging for her. The results of the scan will determine who she should see next: neurosurgeon, spine doc, pain clinic, more PT, or whomever. Back issues are tricky. I suggest she make the effort, if it is necessary to see a specialist, to see the best doctor for the problem even if that means traveling to Milwaukee or wherever a top medical center is near you.

Also, keep track of your expenses so that you can suit them to your auto insurer.

[bean29]

Yes, we have a lawyer handing the auto accident claim. She called his office for advice too. (He is a friend of DH, and I think they want this kind of feedback anyways).

The Family Doctor she was seeing is part of Wheaton Franciscan. They are huge, in our area, but unfortunately losing 1 f 2 doctors in this practice has apparently largely affected them and they are doing a piss poor job of responding to her.  She saw the Physicians assistant there and she must have ordered some X-rays b/c she referred DD for PT. 

For the locals, my city is getting Medical facilities for Aurora and Froedtert (but they are about a year out), and Wheaton Franciscan has an Orthopedic hospital close to our house.  Most of the big players in the Milwaukee Market don't seem to be in the Janesville area. 

Thanks Drama and GRG I will let her know when I get home.  I forgot my phone today, and I am kind of lost without it.  Aren't cell phones great?  DD did not get a response from me on my cell so she called me on the office number (lol).

For the record, I did tell her pretty much what you said GRG about back injuries.  I also told her there was a chance she would hear from the Doctor's office yet today as they tend to do call backs at the end of their day, we shall see.

[tskeeter]

Feb 2, 2017 17:04:19 GMT -5 NomoreDramaQ1015 said:

Dr. Google says look for an orthopedic doctor

www7.aaos.org/member/directory/definition.htm

I agree. DD should see an orthopedic specialist.

[Pants]

Feb 2, 2017 18:03:10 GMT -5 bean29 said:

Yes, we have a lawyer handing the auto accident claim. She called his office for advice too. (He is a friend of DH, and I think they want this kind of feedback anyways).

The Family Doctor she was seeing is part of Wheaton Franciscan. They are huge, in our area, but unfortunately losing 1 f 2 doctors in this practice has apparently largely affected them and they are doing a piss poor job of responding to her.  She saw the Physicians assistant there and she must have ordered some X-rays b/c she referred DD for PT. 

For the locals, my city is getting Medical facilities for Aurora and Froedtert (but they are about a year out), and Wheaton Franciscan has an Orthopedic hospital close to our house.  Most of the big players in the Milwaukee Market don't seem to be in the Janesville area. 

Thanks Drama and GRG I will let her know when I get home.  I forgot my phone today, and I am kind of lost without it.  Aren't cell phones great?  DD did not get a response from me on my cell so she called me on the office number (lol).

For the record, I did tell her pretty much what you said GRG about back injuries.  I also told her there was a chance she would hear from the Doctor's office yet today as they tend to do call backs at the end of their day, we shall see.

She needs to get an MRI. An XRay will not show many things which might be bothering her.

[dannylion]

If she can get an appointment with a new primary care doctor (internal medicine, family medicine), that doctor could order imaging (x-rays, MRI, CAT scan, whatever might be needed) and provide a referral to an orthopedic specialist (preferably a spine specialist, who will by definition be a surgeon--orthopods are surgeons). Having the imaging in hand when she sees the specialist will streamline the development of a treatment plan.  Either the internist/PCP or the orthopod could order physical therapy, which would likely be the first step unless contraindicated by the imaging results, so seeing a PCP might be all she needs.  If there is no skeletal damage, physical therapy might provide relief along with some short-term medication until the PT does its magic. 

ETA:  She might need a referral from a PCP or orthopod to see a physiatrist or pain-management specialist. In any event, pain management would probably want her to be evaluated before treating her.

[wvugurl26]

I started with the ortho surgeon. I had a fairly recent knee surgery at the time. I just got an appointment with the back/neck guy in the group.

I did some PT I think at that point? All my sessions have run together at this point.

My sympathy for her. I remember those days where sitting was akin to torture. Those were some rough days. Even now if I sit for too long, my body will just spazz out until I can get up and move or lay down.

[milee]

I'm sorry your daughter is having that pain - back pain is horrible and really impacts your whole life.  Hopefully she can get help.

Just as a general rule, I avoid going to any type of specialist that is a surgeon unless I'm positive I need surgery.  Not that every surgeon is overeager, but there is something to the saying about if your only tool is a hammer, everything looks like a nail.  If your daughter could start with the nonsurgeon specialists - Physiatrist, for example - IMHO that would be a better start at potentially getting a wide range of options.  It may be that she ends up needing surgery but especially with back surgery, I'd be trying all other options first.

Good luck.

Oh, and if she goes to a doc that wants to put her on opioids for pain, think long and hard before doing that.  Increasing data is showing that opiods are not only not effective for long term pain management for back injuries, but there's a very real risk for addiction.  That's why we're seeing such surges in opioid addiction.  They're overprescribed and prescribed for the wrong thing and it's really easy to fall into addiction.

[Cookies Galore]

I'd go with orthopedist or PM.

As far as PT goes (and I adore my PT guy!) yeah, they schedule you far in advance. I've always scheduled my appointments a month at a time.

A good orthopedic surgeon will have you try everything leading up to surgery.

[dee27]

Feb 2, 2017 22:19:05 GMT -5 Cookies Galore said:

I'd go with orthopedist or PM.

As far as PT goes (and I adore my PT guy!) yeah, they schedule you far in advance. I've always scheduled my appointments a month at a time.

A good orthopedic surgeon will have you try everything leading up to surgery.

 I would not continue to see a orthopedic surgeon who pushed surgery as the ONLY option. I have been fortunate that surgery was presented as the last option after other interventions failed.

[wvugurl26]

Even though my doctor was classified as a surgeon, he didn't do back surgery. Only one guy did and I never needed to see him.

I think it depends on the doctor. There's an ENT in my allergy/ENT practice who told me immediately the first time I saw him that I needed to get my deviated septum fixed. I just brought it up to my regular ENT and he says not at all right now. So some just push surgery.

[suesinfl]

Is it bone pain or muscle pain? I found that a well trained message therapist can help a lot. I'm not talking about some one that gives relaxation messages, but someone that specializes in accidents.

I had my doubts, but the lady I went to was a life saver. Just be careful of who you/she chooses.  

[alabamagal]

Orthopedic doctor definitely.  We had a close friend who was orthopedic doctor when we lived in GA, and we miss him!  He was in alarge practice and they did everything in house - x-rays, MRIs, physical therapy.  We went to him for lots of aches and pains, sports injuries, broken bones, etc.  Never felt like they were pushing surgery at all.

[GRG a/k/a goldenrulegirl]

A good neurosurgeon won't hesitate to tell you that surgery won't help and can direct you to treatments that can.  While DH felt immediate relief after both of his back surgeries, his neurosurgeon was quick to tell him his current issues aren't suitable for surgical treatment.  

And, if surgery will help, my DSIL, who works in risk management for a large urban trauma center, says that the best neurosurgery training program is at Johns Hopkins.  That doesn't mean you need to go to Baltimore -- just try and find a Hopkins-trained neurosurgeon in your area.  

[bean29]

Thanks everyone.

I forwarded her a link to this page, if she can't access it, I will print it out for her. She is scheduled to work all weekend so I probably won't see her for a while.

[The Walk of the Penguin Mich]

Late to this, but a good orthopedic surgeon should only recommend surgery as a last resort.  Your daughter should have gone to one after the accident to make sure she didn't have any broken bones.  When Imaging is done in this setting, they are not only read by the OS but the radiologist too, so you have at least 2 sets of eyes looking for problems.

Many OS have specialized, so it would be best that she finds one who works on the spine.  My OS ONLY does hips.  It limits him, but he is very, very good.  In fact, I saw him a few months ago and wanted him to look at my thumb as it still hurts from a fall I took.  He wouldn't, because he doesn't do hands.  All the OS in his practice only do a particular body part.  A friend of mine goes there, and her shoulder surgeon is as good as my hip.

Only after she has rules out an structural problems, she should see someone else.  OS do not deal with soft tissue injuries as well, but you need to eliminate places where the problems occur.

Personally, I'd bypass internal med.  

[CCL]

I insisted on a neurosurgeon for my back injury. He cured me (so far) without surgery.

[bean29]

Well, DD got a recommendation from the lawyer for a Dr, he is listed in my ins as being at the Medical College of WI, but the lawyer listed him having a local office, and I found some notes from her Pediatric Orthopedic Dr on recommended Dr at an Orthopedic Hospital abt 2 miles from my house. Only problem is note said esp. shoulder not back. My note also named a Dr. in that practice to avoid.

In other disturbing news DD went to get her eyes checked, and her eyes have changed significantly in last 3 years, -1,-3,-2, Eye Dr was concerned b/c she said she usually dosn't she that back & forth up/down bounce in prescriptions unless patient is Diabetic. DD said she told her well, my Dad is Diabetic, Both my grandparents are Diabetic, 2-3 Uncles are Diabetic and one cousin (Cousin has Diabetes on both sides of family though). So, we gave her DH's Dr. name to get initial bloodwork done. My inlaws see same Dr. as DH. She has had practice for a few yrs. took over practice from DH's childhood Dr, she is listed in Ins. Website as internal medicine Dr. If she has Diabetes I think I will have her see my Endocrinologist or my BIL's (He lives close to where DD goes to school). Eye Dr. was concerned that with so much diabetes in family Dr. never did blood panel before. (Eta. I am not diabetic, I see endocrine dr. B/c my Thyroid was removed. My Endocrinologist has a large #of Diabetic patients).