Pain Questions & Answers

I’m an amputee in pain. Do I have Neuropathic Pain?

admin — Thu, 03 Dec 2009 21:30:52 +0000

Neuropathic pain is an on-going chronic pain that results from various types of injuries to the nervous system. This may include injury to the brain or spinal cord, or an injury that has damaged the nerves outside the spine or brain.

Do amputee’s often have neuropathic pain? Yes, this is a fairly common ailment that many patients complain of when they have had to have a limb removed by amputation. The name of the condition is called phantom limb syndrome. It is caused because the brain is still receiving messages from the area of the missing limb, which causes pain.

What are some of the other causes of neuropathic pain? There can be many reasons that a person may suffer from neuropathic pain. Besides being an amputee, if a person is an alcoholic it may cause the chronic pain associated with neuropathic pain. Many patients with diabetes also show symptoms of this, along with patients that are receiving certain types of chemotherapy drugs. Disease’s such as AIDS and Multiple Sclerosis are also known to cause neuropathic pain.

Why does nerve damage cause chronic neuropathic pain? This type of pain is brought on by the nerve fibers becoming damaged. It may also be caused by the nerve fibers becoming dysfunctional due to an on-going illness or disease. Because they nerve fibers are damaged in some way they start sending improper signals to the pain center of the brain.

How do I know if the pain I’m having is neuropathic pain? One of the symptoms of neuropathic pain is a tingling feeling around the injured area. A person may also have numbness along with the tingling sensation. Sharp shooting pains may also be a sign of neuropathic pain, as can a burning type of pain at or around the sight of the injury.

How will my doctor find out if I have neuropathic pain? Your doctor may suspect that you suffer from neuropathic pain by a variety of questions that are asked about your past health history. He or she will also give you a complete physical examination. You will be asked to describe the type of pain you are having. After receiving a diagnosis of neuropathic pain the patient may be sent you to a pain management specialist.

I am experiencing burning pain, what do I do?!

admin — Mon, 30 Nov 2009 17:13:10 +0000

Burning pain is defined as a sensation that feels as though the affected body part is being subjected to heat of varying intensity. The causes can be linked to injury, disease, psychological condition, neurological disorder or the side effects of drugs.

Burning pain can occur in or be referred to any portion of the anatomy. The most reported types of burning pain are Central Pain Syndrome, Meralgia, Mononeuritis, Paget’s Disease of the Scrotum, Reflex Sympathetic Dystrophy Syndrome and St. Anthony’s Fire.

Central Pain Syndrome is a neurological condition caused by injury or dysfunction of the central nervous system. The syndrome is caused by stroke, trauma, tumor, multiple sclerosis, epilepsy or Parkinson’s disease. The pain can affect a large portion of the body or be restricted to smaller areas such as the hands or feet. The pain varies from constant to intermittent or as intense pain lasting only moments.

While the disorder is not fatal, the pain can be disabling and the suffering severe. Meralgia is a neurological disorder affecting the lateral cutaneous nerve of the thigh. The disorder is typically caused by compression of the nerve that runs in front of and to the upper tip of the hipbone.

Pain can be moderate to severe and usually lasts 4 to 6 weeks or sometimes much longer.

Patient’s Question:
“I have developed an intense burning pain in my upper right thigh that spreads across my buttocks. What is going on?”
Answer:
“Jean’s Disease” is a term sometimes used for this condition. Causes could include wearing restrictive clothing such as tight low rider jeans, a girdle or a tight belt. Weight gain can put pressure on the affected nerve as can wearing a heavy tool belt. Loose clothing, restriction of exercise and muscle relaxants is the first course of treatment.

Patient’s Question:
“I have Central Pain Syndrome and I find myself constantly afraid because I never know when the burning sensation in my hands will suddenly become intolerable.”
Answer:
Talk with your doctor about Tricyclic antidepressants such as nortriptyline or anticonvulsants such as neurontin (gabapentin). An activity that takes your mind off your disorder may reduce stress levels which appear to reduce pain.

Mononeuritis, Paget’s Disease of the Scrotum, Reflex Sympathetic Dystrophy Syndrome and St. Anthony’s Fire are less commonly reported types of burning pain and have many different causes and treatments.

Do I have chronic pain? Arthritis? Pain Disease?

admin — Mon, 30 Nov 2009 17:11:35 +0000

Question: Recently, I have been experiencing a lot of chronic pain. It started out as a little bit of soreness here and there, but now, I usually have pain in my muscles and joints quite frequently. The pain isn’t really intense, just a dull, nagging ache everywhere. Some days, it makes me not want to even get out of bed. I cannot figure out what is wrong. Does this mean I have arthritis? Do I have some other type of disease? What do I do? I used to be an athlete and never thought I’d struggle with chronic pain like this, but it makes me quite miserable. I want my life back!

Answer: The moment I read “I used to be an athlete”, I was able to answer your question. I too, used to be an athlete, always working out, at the gym, running, jumping, or something. I watched my diet, got the proper amount of sleep, and lived a life of activity and discipline. However, when my athletic years came to an end, I ceased this type of lifestyle. I too, began to struggle with chronic pain. I was always achy and sore, tired and somewhat out of it.

It is true that some people who are experiencing chronic pain are suffering from a disease like arthritis. It certainly doesn’t hurt to visit your primary doctor and get a diagnosis. But, far too many people attribute their pain and discomfort to some serious disease or disorder while in fact, most of their pain comes from an improper diet and lack of activity.

If you want your life back, you have to do something about. No pill popping for you! Start moving! Fit exercise into your day, every day. Dance, ride your bicycle, go for a jog, or join a yoga class. You can even switch if you like to keep things fresh. Try to incorporate a good mix of aerobic exercise, weight-bearing exercise, and stretching to ensure the best results. Along with your increased moving, drink more water and less sugary and caffeinated drinks. Try to eat vitamin and mineral rich foods, cutting back on heavy carbs and simple sugars. Finally, make sure you’re getting the right amount of sleep and sleeping on a mattress that offers proper support.

If you’re anything like me, you won’t be complaining about your chronic pain for too much longer! So, get of the couch and take your life back!

Can someone tell me some information about foot pain?

admin — Mon, 30 Nov 2009 17:10:39 +0000

What is foot pain?

Foot pain is any type of pain that occurs in the foot or the feet.

What causes foot pain?

Foot pain can be caused by many different things. Sometimes foot pain is caused by an accident or injury like falling or tripping over something. Sprained ankles are a very common type of foot injury that results in pain. Sometimes a sprain can be so painful that you will think you’ve broken a bone. A sprain is a lot less serious than a broken bone, however. Sometimes your feet can hurt for no apparent reason. If you’re feet are hurting and you don’t know why, it could be because you are wearing uncomfortable or poorly fitting shoes. It could also be because you’ve been on your feet for a long period of time. Some diseases like diabetes and gout can result in foot pain. An ingrown toenail can also cause a great amount of pain in the foot if it becomes infected.

How can I treat my foot pain?

Unless foot pain is severe or you suspect you’ve broken a bone, you can treat your foot pain at home. Many over the counter medications will work well for treating foot pain. Things you probably have on hand like aspirin and Tylenol work great to treat minor foot pain. If your feet are aching from overuse, a good massage or soaking them in a tub of hot water can work wonders to ease the discomfort.

Do I need to see a doctor for my foot pain?

If you have tried to treat your foot pain at home and have had no success, you may need to see a doctor for your foot pain. A doctor will be required to treat a broken bone, fracture, or sprain. If your foot pain is caused by a disease you may have, a doctor will also be necessary. Most of the time your instincts will be correct. If you have a feeling that your foot pain is serious and not something minor, you should go see a doctor. If you think it’s something that will either go away on it’s own or can be treated at home, try staying at home and tending to your foot yourself. If the pain persists for 3 or more days, consult a doctor.

What are the underlying causes of hip pain?

admin — Mon, 30 Nov 2009 17:10:06 +0000

Hip pain is as common as heartburn, and almost everyone can experience it. What causes hip pain? There are quite a few causes, with quite a few treatments. Arthritis, tendonitis, muscle strains, and osteonecrosis are just a few causes-with adults, that is. In children, developmental dysplasia and leg-calve-perthes disease could be a reason for that nagging hip pain. How can it be stopped? There are treatments available for most problems.
Arthritis usually affects persons over 50 years old, and is most common in overweight people. Losing weight can take the pressure away from the hip. Hip surgery, physical therapy, and joint supplements are all common treatments for arthritis.
When the tendons surrounding the hip joint become inflamed and irritated, the most likely problem is tendonitis. Tendonitis is caused by overuse and age. When injured after exercise, ice helps. Physical therapy, cortisone injections, and anti-inflammatory medications are all treatments to help with tendonitis.
Osteonecrosis is caused by lack of blood flow to a certain bone. When there is no blood flow, cells die and the bone may collapse. Anti-inflammatory medications, bone grafts, hip decompression, or hip resurfacing surgery are all common treatments for Osteonecrosis.
Muscle strains, such as pulling the groin or hamstring strains, are caused by pulling a muscle or stretching it too far. Muscle is connected to tendon, which is in turn connected to the bone itself. The treatment for a strain is simple- ‘RICE’. Rest, plenty of ice on the strain, keep it compressed by using an ace bandage, and keep it elevated.
When a hip is dislocated during infancy, it may not grow properly and can cause early arthritis. This is called developmental dysplasia and can be fixed by using the Pavlik harness or a spica cast.
Perthes disease is similar to Osteonecrosis, only it takes place during childhood. Treatment usually requires relief medication and maintaining hip motion.

Arthritis, tendonitis, Osteonecrosis, muscle strains, dysplasia and perthes disease are only a few problems concerning hip pain. There are thousands more, and nearly all of them are caused by overuse. The best way to avoid hip pain completely is to know your limits.

Can lifting heavy objects cause lower left back pain?

admin — Mon, 30 Nov 2009 17:09:31 +0000

The answer to this question is yes, lifting heavy objects can cause lower left back pain. Many times when lifting even a lighter weight object the muscles in the lower back can become sprained.The severity of the pain will vary with each individual depending on how badly the muscles are strained. Most often the treatment for a simple back sprain that causes lower left back pain is rest and possibly the use of a heating pad. The individual suffering from lower left back pain should seek a physicians advice if the muscle pain does not go away within a few days. At times, lifting a heavy object may cause ligaments to stretch. In this case a doctor’s opinion should be sought.

Can a herniated disc cause lower left back pain? Yes it can. Herniated or ruptured disc’s in the lower back may cause miner to severe lower left back pain. It may also be a sign of a degenerative disc disease that should be diagnosed by the family physician or an orthopedic doctor. A herniated or ruptured disc that causes lower left back pain may be because a disc in the lumbar section of the spine has been affected.

How many people suffer from lower left back pain? In the United States alone, one of the most common ailments that patients seek treatment for is lower back pain which can be on either the left lower back area or the right. It is one of the leading reasons for appointments at family physicians, chiropractors and orthopedic doctors. It is stated that four out of five adults will go to the doctor at some point in their lifetime for lower left back pain.

If I am experiencing severe lower left back pain, should I see my doctor? Anyone that is experiencing severe lower left back pain that is not relieved by rest, heat applications or over the counter medications should see their doctor. Lower left back pain that refuses to go away can signify a number of more serious causes. One of these can be that the lower left back pain is caused by an abdominal aortic aneurysm. This can be a life threatening condition and the individual should seek medical attention promptly. A simple sonogram which is not painful, can confirm the diagnosis of this condition. Another serious condition that can cause lower left back pain may be a kidney stone. This is said to cause severe pain in both genders, but especially in males. If a person suffers from a sudden bowel or bladder problem they should also seek professional medical help to rule out a syndrome called cauda equina syndrome.

My sciatica pain – I need help! Any advice?

admin — Mon, 30 Nov 2009 17:08:32 +0000

A: Sciatica is a term used to define the symptoms of pain and tingling in the legs and numbness or weakness traveling from the lower all the way down the back of the leg where the large sciatic nerve is. Sciatica is not a medical diagnosis or medical disorder; it is actually just a symptom of when the nerve roots which make up the sciatic nerve or compressed or irritated. It usually occurs most frequently between people age 30 to 50. It is typically developed over general wear and tear and not from a particular event or injury. Clinically, sciatica is called radiculopathy, meaning that a disc has moved from its original placement in the vertebral column and putting pressure on the radicular nerve.

The pain of sciatica on occasion can be very intense and debilitating. Typically, however, the pain is bearable, irritating, and inconsistent. When the pain is this mild, it is usually caused by some inflammation and can heal anytime between two weeks to a couple months. Because the spinal cord is not located in the lower back where sciatica occurs, it does not impose the danger of paralysis as some nerve conditions in the back do. If progressive weakness in the leg continues for a prolonged period of time or there is any bladder or bowel incontinence or dysfunction, it is important to seek medical help.

When sciatica becomes more severe it is necessary to get medical treatment. Because sciatica nerve pain is linked to a combination of inflammation and pressure onto the nerve root, its treatment focuses on relieving these conditions. There are two common treatments to heal sciatica and relieve the pain completely. If surgery isn’t an option there is a combination of treatments and alternative non-medical treatments to relieve the pain. They typically have a combination of back exercises and stretching. If done correctly, these exercises should prevent reoccurrence of sciatica symptoms. If the condition is severe enough, surgery may be the only option. Microdiscectomy, or lumbar lamienctomy and discectomy, extracts a part of the disc that is causing inflammation on the nerve root. These surgery’s relieve any inflammation and pressure that cannot be treated with non-medical treatments.

hey…looking for positive feedback.

admin — Sun, 18 Feb 2007 05:00:00 +0000

Question:

Are you tightening up, Rob? I’ll bet you are. That’s why your back is hurting you. I think I’d give the new doc a chance and if you feel you aren’t getting any real help soon then go back to your old doc. I’m assuming he’ll take you back. Just trying to think of something to help you. {{{{{Rob}}}}} Di

– Hide quoted text — Show quoted text – Hi ASAP. Seems like the 3x/day (.25) xanax isn’t helping me…..(ok, I sometimes sneak in an extra 1/2 or 1 pill from my rainy day secret supply). I’m having a very difficult time focusing on anything other than "how am I doing" or "why don’t I feel 100%" . Still have a chill or intense tingling from the base of my neck to middle of the back…..am sore too in a few spots on my shoulder blades & back. That is driving me insane I think. Even when my mind is focused on something else, the back sensation is present 24×7 (it sure seems like it). I don’t have another Doc appointment until mon.26th…..so I guess I will wait it out in misery. (unless by a miracle I start feeling well). There’s a part of me that wants to run back to my old doc for advise/treatment – the dr. that worked with my anxiety/panic from day 1 (10 yrs. ago ’til 2006). I guess since I now feel lousy, and have a new dr., I’m placing some of the blame of not feeling 100% yet on their office….which probably isn’t right. So, a part of me is saying, give the new doc. the opportunity to help you even though its taking a while…..I dunno…..I keep worrying and just want it to end. If you want to e-mail me, I’d gladly try to listen to reason, relaxation suggestion, etc…. You can reach me at "the.z.guy" AT comcast DOT net -take care everyone, z [Rob]

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hi, z, Keep the positive thinking going… smiles, Elise

– Hide quoted text — Show quoted text – THANKS EVERYONE! Your thoughts and words are very encouraging. I can’t thank all of you enough. When I’m better, I think I’ll make a few adjustments to try to ward this off in the future. Although my back is still irritating, my thoughts are clearer and more positive. I’m glad ASAP-M is here! regards, z [Rob] Hi ASAP. Seems like the 3x/day (.25) xanax isn’t helping me…..(ok, I sometimes sneak in an extra 1/2 or 1 pill from my rainy day secret supply). I’m having a very difficult time focusing on anything other than "how am I doing" or "why don’t I feel 100%" . Still have a chill or intense tingling from the base of my neck to middle of the back…..am sore too in a few spots on my shoulder blades & back. That is driving me insane I think. Even when my mind is focused on something else, the back sensation is present 24×7 (it sure seems like it). I don’t have another Doc appointment until mon.26th…..so I guess I will wait it out in misery. (unless by a miracle I start feeling well). There’s a part of me that wants to run back to my old doc for advise/treatment – the dr. that worked with my anxiety/panic from day 1 (10 yrs. ago ’til 2006). I guess since I now feel lousy, and have a new dr., I’m placing some of the blame of not feeling 100% yet on their office….which probably isn’t right. So, a part of me is saying, give the new doc. the opportunity to help you even though its taking a while…..I dunno…..I keep worrying and just want it to end. If you want to e-mail me, I’d gladly try to listen to reason, relaxation suggestion, etc…. You can reach me at "the.z.guy" AT comcast DOT net -take care everyone, z [Rob] — The charter is available at: http://readystump.algebra.com/~asapm

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

::Still have a chill or intense tingling from the base of my neck to middle of ::the back…..am sore too in a few spots on my shoulder blades & back. That ::is driving me insane I think. Even when my mind is focused on something ::else, the back sensation is present 24×7 (it sure seems like it). Long, hot showers, ice the sore spots, use motrin as needed, start practicing deep breathing and muscle relaxation exercises and have the wife rub you down with Bengay or something similar. Since this seems to be your most distressing symptom, work on lessening it. Take it one day at a time! I know it feels like it will last forever, but it won’t. Nothing lasts forever, not even bad times Jackie ~*~"It’s the crazy ones that have all the good pills"~*~ ~~Kim Cattrall — The charter is available at: http://readystump.algebra.com/~asapm

Response:

THANKS EVERYONE! Your thoughts and words are very encouraging. I can’t thank all of you enough. When I’m better, I think I’ll make a few adjustments to try to ward this off in the future. Although my back is still irritating, my thoughts are clearer and more positive. I’m glad ASAP-M is here! regards, z [Rob]

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hi ASAP. Seems like the 3x/day (.25) xanax isn’t helping me…..(ok, I sometimes sneak in an extra 1/2 or 1 pill from my rainy day secret supply). I’m having a very difficult time focusing on anything other than "how am I doing" or "why don’t I feel 100%" . Still have a chill or intense tingling from the base of my neck to middle of the back…..am sore too in a few spots on my shoulder blades & back. That is driving me insane I think. Even when my mind is focused on something else, the back sensation is present 24×7 (it sure seems like it). I don’t have another Doc appointment until mon.26th…..so I guess I will wait it out in misery. (unless by a miracle I start feeling well). There’s a part of me that wants to run back to my old doc for advise/treatment – the dr. that worked with my anxiety/panic from day 1 (10 yrs. ago ’til 2006). I guess since I now feel lousy, and have a new dr., I’m placing some of the blame of not feeling 100% yet on their office….which probably isn’t right. So, a part of me is saying, give the new doc. the opportunity to help you even though its taking a while…..I dunno…..I keep worrying and just want it to end. If you want to e-mail me, I’d gladly try to listen to reason, relaxation suggestion, etc…. You can reach me at "the.z.guy" AT comcast DOT net -take care everyone, z [Rob] — The charter is available at: http://readystump.algebra.com/~asapm

Response:

- Hide quoted text — Show quoted text – Hi ASAP. Seems like the 3x/day (.25) xanax isn’t helping me…..(ok, I sometimes sneak in an extra 1/2 or 1 pill from my rainy day secret supply). I’m having a very difficult time focusing on anything other than "how am I doing" or "why don’t I feel 100%" . Still have a chill or intense tingling from the base of my neck to middle of the back…..am sore too in a few spots on my shoulder blades & back. That is driving me insane I think. Even when my mind is focused on something else, the back sensation is present 24×7 (it sure seems like it). I don’t have another Doc appointment until mon.26th…..so I guess I will wait it out in misery. (unless by a miracle I start feeling well). There’s a part of me that wants to run back to my old doc for advise/treatment – the dr. that worked with my anxiety/panic from day 1 (10 yrs. ago ’til 2006). I guess since I now feel lousy, and have a new dr., I’m placing some of the blame of not feeling 100% yet on their office….which probably isn’t right. So, a part of me is saying, give the new doc. the opportunity to help you even though its taking a while…..I dunno…..I keep worrying and just want it to end.

I’m so sorry to read how bad you’re feeling Z. I wish I had the secret to get better but I don’t. If I can’t help, at least I can wish you well. Tony — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Which one causes the other? Short of an identifiable physical reason, are you anxious because you feel unwell, or the other way around? I have finally realized that "phantom" pain is a way my anxiety manifests itself, which makes me focus on what is "wrong", which makes anxiety worse…. oy. Of course it is important to make sure one is well medically first. I recall a few years ago having abdominal pain for about a month, which coincided with a job change and the unravelling of a relationship with an ex-girlfriend. It wasn’t until I was diagnosed with anxiety that I realized it was psychosomatic. Of course at the time, it didn’t feel like it! I will say that anxiety can also present actual physical symptoms. After my Mom died I developed a benign heart arrthyhmia and had it checked out by a cardiologist. After a battery of tests, the whole enchilada (I was 28 and healthy as a horse), the doctor asked me if I had experienced anything traumatic recently. When I told him of my Mom’s death he smiled gently and told me he felt that was the cause based on all of my tests which showed nothing seriously wrong. I guess it is nice to know you are okay, but damn frustrating to not FEEL okay. Are you getting out and doing things? Talking to family/friends? I hope you are doing well. I know how frustrating it can be and can tell you from experience it can and will get better. Hang in there!!! — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hi ASAP. Seems like the 3x/day (.25) xanax isn’t helping me…..(ok, I sometimes sneak in an extra 1/2 or 1 pill from my rainy day secret supply).

Haaaaaaaaa I have a secret supply as well ! I love to watch those little blue pills (valium ) I’m having a very difficult time focusing on anything other than "how am I doing" or "why don’t I feel 100%" .

Still have a chill or intense tingling from the base of my neck to middle of the back…..am sore too in a few spots on my shoulder blades & back. That is driving me insane I think. Even when my mind is focused on something else, the back sensation is present 24×7 (it sure seems like it).

Yup we are good at multitasking when it comes to our disorders huh ?????? I don’t have another Doc appointment until mon.26th…..so I guess I will wait it out in misery. (unless by a miracle I start feeling well). There’s a part of me that wants to run back to my old doc for advise/treatment – the dr. that worked with my anxiety/panic from day 1 (10 yrs. ago ’til 2006). I guess since I now feel lousy, and have a new dr., I’m placing some of the blame of not feeling 100% yet on their office….which probably isn’t right. So, a part of me is saying, give the new doc. the opportunity to help you even though its taking a while…..I dunno…..I keep worrying and just want it to end.

The starnge thing with us is the harder we try the worst is coming For me it helps to ultra focus on what I am feeling thinking and my worries and than think SO WHAT ? It sounds weird but for me it does the trick I wished i could be a better supports person ! If you want to e-mail me, I’d gladly try to listen to reason, relaxation suggestion, etc…. You can reach me at "the.z.guy" AT comcast DOT net -take care everyone, z [Rob]

You too dear and love from Anna — The charter is available at: http://readystump.algebra.com/~asapm

Response:

I am so sorry, Rob. I wish I could offer advice. All I can give you is my sympathy. No one can truly understand what anxiety does to a person unless they go through it themselves. We all feel it and we’re here for you. Vent away; we’ll listen and hopefully offer help – unlike what I’ve done! kili — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Deviated septum

admin — Wed, 13 Jul 2005 05:00:00 +0000

Question:

Too Old??? medicare pays for alternate therapy for chronic health problems. If Medicare does not approve of a procedure the HMO does not either. shirley

Response:

Probably that they don’t care much about my deviated septum because they are pretty sure it’s not related to my primary problem, which is neck and shoulder pain. This week i went to the doctor and my goal was to ask for the required paper to see a physician. He did not want to and gave me a prescription instead. I tried to explain him that i want to fix the problem, not mask it with pain killers. It’s frustrating. He did not realize that i’ve been suffering for many years, that my condition is serious to the point of quitting my quality job. But don’t get me wrong i’m not complaining about doctors, i appreciate their services. They must see so many people every day that they can’t feel every patient distress correctly. It’s normal. Back to my problem, i went to see another doctor today. He gave me a paper to see an ENT about the deviated septum, good news. About the neck and shoulder pain i was told to make exercices and watch my posture at computer. Looks like the solution to a complicated problem might be simple. Thanks for reading! Matt

Response:

My husband has a deviated septum. He is a Senior and Medicare would not pay for it. They pay for nasal meds with steroids in it. Its been 10 years now. shirley

Response:

On Sun, 17 Jul 2005 10:03:07 -0400, thebagladyshirley…@webtv.net (Shirley Thebaglady) wrote: >My husband has a deviated septum. He is a Senior and Medicare would not >pay for it.

*If* he needs and wants the surgery (after a couple of opinions at least), he should appeal. You will probably find that the policy is along the following lines: "Aetna considers septoplasty medically necessary when any of the following clinical criteria is met: 1. Septal deviation causing continuous nasal airway obstruction resulting in nasal breathing difficulty not responding to appropriate medical therapy; or 2. Documented recurrent sinusitis felt to be due to a deviated septum not relieved by appropriate medical and antibiotic therapy; or …….." – Hide quoted text — Show quoted text ->They pay for nasal meds with steroids in > it. Its been 10 years now.

Response:

My Hubbys nose seems to close up at night and he cannot breath through his nose. He elevates his head at night now and uses Rhinacort so he does not get nasal infections` anymore. His doctor that did the fungal surgery appealed to Medicare but they still said no. shirley

Response:

On Mon, 18 Jul 2005 06:56:24 -0400, thebagladyshirley…@webtv.net (Shirley Thebaglady) wrote: >My Hubbys nose seems to close up at night and he cannot breath through >his nose. >He elevates his head at night now and uses Rhinacort so he does not get >nasal infections` anymore. >His doctor that did the fungal surgery appealed to Medicare but they >still said no.

On what grounds?

Response:

"Matt" wrote in message

news:1121298246.889868.66530@f14g2000cwb.googlegroups.com… >I had constant shoulder, neck, jaw and eye pain for more than 10 years, > mostly on right side. Also my right nostril is often congested for no > reason (no nasal discharge) and i get frequent nosebleeds on the left > side during winter. I was told by two doctors that i have deviated > septum, and this is the cause of my congestion/nosebleeds. Also had > scans for my sinuses, they are clear. They don’t seem to care much > about it. > However, could a deviated septum cause severe muscle pain down to the > shoulder? The facial pain and pain behind the eyes is realistic, but > what about neck and shoulder? I don’t think this is realistic, but i > wish it is! I would not hesitate to have a surgery done then. > Hoping to find answers to run away from hell. Thank you.

Unfortunately, as a doctor I can’t give advice on the Internet regarding your medical problem, but I would advise you to see a different doctor. Several things come to mind which haven’t been pursued by the doctors you’ve seen so far. You could either start with a primary care physician (FP or IM), or go straight to a neurologist. This problem of doctors not seeming to care is pervasive. It results from declining reimbursement rates of insurance companies (which take their lead from Medicare) for primary care physicians, and the consequent need to see lots of patients every day (15 minutes per patient seems to be the best you can do nowadays and still stay in business). However, ultimately the problem is with the individual physicians, who need to find a way to practice within the constraints of the system and still give their patients good care. My approach is to ask patients to come back frequently. The down sides to this approach are (1) the patient has to be lots of co-pays for lots of visits, and (2) you can’t get everything done right now that you’d like to get done. But I see no better solution. There’s really no excuse for a doctor not seeming to care, in my opinion.

Response:

On 13 Jul 2005 16:44:06 -0700, "Matt" wrote: >I had constant shoulder, neck, jaw and eye pain for more than 10 years, >mostly on right side. Also my right nostril is often congested for no >reason (no nasal discharge) and i get frequent nosebleeds on the left >side during winter. I was told by two doctors that i have deviated >septum, and this is the cause of my congestion/nosebleeds. Also had >scans for my sinuses, they are clear

That part is good news but have you had the CT scan looked at personally by a sinus surgery specailist who also examined you? Sometimes things are subtle. >However, could a deviated septum cause severe muscle pain down to the >shoulder? The facial pain and pain behind the eyes is realistic, but >what about neck and shoulder? I don’t think this is realistic, but i >wish it is! I would not hesitate to have a surgery done then.

I do not know about that part – I have my doubts – but I suspect Dr. Grossan or others may have a comment.. Some of it may not be sinus-nasal in origin. Even if you are just looking at a possible minor septal correction I would sugest only considering having a very experienced sinus surgeon (e.g at a major medcial center) do it or give an opinion on it..

Response:

I had constant shoulder, neck, jaw and eye pain for more than 10 years, mostly on right side. Also my right nostril is often congested for no reason (no nasal discharge) and i get frequent nosebleeds on the left side during winter. I was told by two doctors that i have deviated septum, and this is the cause of my congestion/nosebleeds. Also had scans for my sinuses, they are clear. They don’t seem to care much about it. However, could a deviated septum cause severe muscle pain down to the shoulder? The facial pain and pain behind the eyes is realistic, but what about neck and shoulder? I don’t think this is realistic, but i wish it is! I would not hesitate to have a surgery done then. Hoping to find answers to run away from hell. Thank you. Matt

Response:

Test Results (OT)

admin — Fri, 08 Jul 2005 05:00:00 +0000

Question:

Okay, I got a message from the doctor’s office. I have minor arrythmia but it’s "nothing to worry about and no treatment is necessary unless it continues to bother you". Uh… it’s been bothering me, that’s why I went to the doctor! I called back and left a message because this sure does sound ambiguous to me. More later… Jill — I used to have a handle on life…but it broke off.

It does sound like this definitely *has* been bothering you (shoulder pain, lack of sleep, etc.). However, it might give you a bit of comfort to know that my mother was first diagnosed with arrhythmia when she was in high school. She is now 89 years old and has never had a bit of "heart" difficulty. She would sometimes be aware of something that felt like heart palpitatons, but that was annoying rather than dangerous. There were also a couple of instances in her life was doctors delayed surgery because they detected the arrhythmia and wanted to be sure that she was a suitable candidate for surgery. In each case, she was cleared and had the surgery (with no problems) a day or two later. Perhaps this type of event is what your doctor referred to — but if so, he needs to be more forthcoming about your other symptoms. MaryL

Response:

I was just going to ask how you are feeling. Purrs continuing to come your way. Winnie

Response:

Admittedly, I might have a different perspective, but I simply wouldn’t accept not knowing WHICH arrythmia, and how it is being judged minor or not. Now, there’s no question that some arrythmias are, in any form, emergencies. There are others, however, that might just happen every so many beats, and it’s useful to know how frequent the events were now — so that if you have problems in the future, there’s a basis for comparison. It would seem appropriate to sit down for a discussion with a cardiologist, reviewing your symptoms and making a decision whether the arrythmia is causing them or not. A wise physician once said to a group of young doctors, busily looking up lab values, "Gentlemen, treat the patient, not the chart. The chart isn’t sick." Interpretation of tests can go both ways. They can point to disease that needs to be monitored, and can also cause worry over something that truly is not clinically significant. Again, it’s hard to judge without seeing the report. In my own case, I was having significant angina, which did not show up on 12-lead basic EKG, treadmill EKG, or on Holter, because electrically, my heart was essentially normal. It took nuclear scanning to define the problem. Once that showed something, I moved fairly quickly to cardiac catheterization/angiography and then to an angioplasty. One of the major factors in this was having a cardiologist who knew and trusted me, and vice versa, and listened when I said "Michael, I don’t care if the ST segment is isoelectric. I’m having a classic clinical presentation of unstable angina. Keep looking, and observe that medical (drug) therapy isn’t working." I’m really not trying to be alarming, just to point out that cardiology is not cut and dried, and the cardiologist has to treat the patient, not the test.

Response:

- Hide quoted text — Show quoted text – Okay, I got a message from the doctor’s office. I have minor arrythmia but it’s "nothing to worry about and no treatment is necessary unless it continues to bother you". Uh… it’s been bothering me, that’s why I went to the doctor! I called back and left a message because this sure does sound ambiguous to me. More later… Jill Admittedly, I might have a different perspective, but I simply wouldn’t accept not knowing WHICH arrythmia, and how it is being judged minor or not. Now, there’s no question that some arrythmias are, in any form, emergencies. There are others, however, that might just happen every so many beats, and it’s useful to know how frequent the events were now — so that if you have problems in the future, there’s a basis for comparison. It would seem appropriate to sit down for a discussion with a cardiologist, reviewing your symptoms and making a decision whether the arrythmia is causing them or not. A wise physician once said to a group of young doctors, busily looking up lab values, "Gentlemen, treat the patient, not the chart. The chart isn’t sick." Interpretation of tests can go both ways. They can point to disease that needs to be monitored, and can also cause worry over something that truly is not clinically significant. Again, it’s hard to judge without seeing the report. In my own case, I was having significant angina, which did not show up on 12-lead basic EKG, treadmill EKG, or on Holter, because electrically, my heart was essentially normal. It took nuclear scanning to define the problem. Once that showed something, I moved fairly quickly to cardiac catheterization/angiography and then to an angioplasty. One of the major factors in this was having a cardiologist who knew and trusted me, and vice versa, and listened when I said "Michael, I don’t care if the ST segment is isoelectric. I’m having a classic clinical presentation of unstable angina. Keep looking, and observe that medical (drug) therapy isn’t working." I’m really not trying to be alarming, just to point out that cardiology is not cut and dried, and the cardiologist has to treat the patient, not the test.

I am scheduled to go in and talk with my doctor on Monday afternoon. He is not a cardiologist but I’m not willing to let them just say don’t worry about it. If I have to demand a referral to a cardiologist, so be it. Because whatever it is, whether it’s my heart causing the arm/shoulder pain or something as simple as a pinched nerve, I want to know and I want it treated. Period. Jill

Response:

– Hide quoted text — Show quoted text – Okay, I got a message from the doctor’s office. I have minor arrythmia but it’s "nothing to worry about and no treatment is necessary unless it continues to bother you". Uh… it’s been bothering me, that’s why I went to the doctor! I called back and left a message because this sure does sound ambiguous to me. More later… Jill Admittedly, I might have a different perspective, but I simply wouldn’t accept not knowing WHICH arrythmia, and how it is being judged minor or not. Now, there’s no question that some arrythmias are, in any form, emergencies. There are others, however, that might just happen every so many beats, and it’s useful to know how frequent the events were now — so that if you have problems in the future, there’s a basis for comparison. It would seem appropriate to sit down for a discussion with a cardiologist, reviewing your symptoms and making a decision whether the arrythmia is causing them or not. A wise physician once said to a group of young doctors, busily looking up lab values, "Gentlemen, treat the patient, not the chart. The chart isn’t sick." Interpretation of tests can go both ways. They can point to disease that needs to be monitored, and can also cause worry over something that truly is not clinically significant. Again, it’s hard to judge without seeing the report. In my own case, I was having significant angina, which did not show up on 12-lead basic EKG, treadmill EKG, or on Holter, because electrically, my heart was essentially normal. It took nuclear scanning to define the problem. Once that showed something, I moved fairly quickly to cardiac catheterization/angiography and then to an angioplasty. One of the major factors in this was having a cardiologist who knew and trusted me, and vice versa, and listened when I said "Michael, I don’t care if the ST segment is isoelectric. I’m having a classic clinical presentation of unstable angina. Keep looking, and observe that medical (drug) therapy isn’t working." I’m really not trying to be alarming, just to point out that cardiology is not cut and dried, and the cardiologist has to treat the patient, not the test. I am scheduled to go in and talk with my doctor on Monday afternoon. He is not a cardiologist but I’m not willing to let them just say don’t worry about it. If I have to demand a referral to a cardiologist, so be it. Because whatever it is, whether it’s my heart causing the arm/shoulder pain or something as simple as a pinched nerve, I want to know and I want it treated. Period.

Unless your primary physician is in a very large group practice, there may very well be a cardiologist already involved. These days, Holter recordings are analyzed by special-purpose computers that tend to be cost-justified only by cardiologists. In other words, just as if you had an X-ray taken and there would be a radiologist report, there’s probably a cardiologist’s report with the Holder interpretation.

Response:

Jill, That is the best attitude to have when going in to talk to your doctor. You and your doctor are in a partnership regarding your health. Don’t be afraid to stand up for what you know and feel. Good luck! Diane

Response:

Please let us know what the doctor says (is that what’s causing the shoulder pain, or is that from something else that *does* need to be treated?). Whatever it is, purrs that it stop bothering you. Hugs, CatNipped – Hide quoted text — Show quoted text – More later… Jill — I used to have a handle on life…but it broke off.