Confused...again.

[My Monster]

I will attempt to not get long-winded. I have been going to PT for my neck and shoulder. PT won't touch my shoulder until I go to Ortho, well I did that today. He says he wants to do surgery but won't do surgery on my rotator cuff until I get some more ROM in it first. He did give me a Cortizone shot and a note to PT to start on my shoulder. With me so far? Ortho says, yes there is arthritis, yes there is separation and yes RC is a fricken mess that will require surgery. He looked at my neck x-rays, (they were on the same CD) and stated that I need to get to a Neurosurgeon, that it looks "real bad". Great. He spent a lot of time looking and talking about my neck. He said that I am looking at surgery on my neck based off the x-rays and wanted to know why I was going to a Neurologist before a Neurosurgeon. I told him that my Primary wanted an EMG done first to figure out where my nerves were getting pinched off. So it ended with him telling me I needed to prioritize my surgeries.

1. Epidural for my lumbar spine. (Kinda want to hold off on that until I get my "new" C&P exam, SC for 10% DDD.)

2. Knee surgery to clean out some of my meniscus (10% SC for arthritis, didn't know you could claim meniscus separately but will put in for it.)

3. Shoulder surgery (VA denied and diagnosed shoulder strain, well I am going to fight that one with them as it is now diagnosed as arthritis, separation and R/C.)

4. Cervical neck surgery ( based off of the Ortho doc's opinion, and my Primary's.)

Which to do first...? I put in a claim for my neck, received the Notice to Assist, will send it back asking for more time to gather my "evidence" ( doc write-ups, MRI's and Radiologist's Report ). My VSO is waiting for my EMG results to fight my CTS denial, the Ortho and PT report to fight the shoulder denial. I am so fricken' confused on what to do...I am coming up on my 1-year post retirement date. I don't want to take the damn "shot-gun approach, but several of my doc's have said that I have a multitude of problems that I should of had addressed while I was on Active Duty and are amazed that I made it this far before bitching about the pain.

HELP!!!

Monster

[blackbird]

I will attempt to not get long-winded. I have been going to PT for my neck and shoulder. PT won't touch my shoulder until I go to Ortho, well I did that today. He says he wants to do surgery but won't do surgery on my rotator cuff until I get some more ROM in it first. He did give me a Cortizone shot and a note to PT to start on my shoulder. With me so far? Ortho says, yes there is arthritis, yes there is separation and yes RC is a fricken mess that will require surgery. He looked at my neck x-rays, (they were on the same CD) and stated that I need to get to a Neurosurgeon, that it looks "real bad". Great. He spent a lot of time looking and talking about my neck. He said that I am looking at surgery on my neck based off the x-rays and wanted to know why I was going to a Neurologist before a Neurosurgeon. I told him that my Primary wanted an EMG done first to figure out where my nerves were getting pinched off. So it ended with him telling me I needed to prioritize my surgeries.

1. Epidural for my lumbar spine. (Kinda want to hold off on that until I get my "new" C&P exam, SC for 10% DDD.)

2. Knee surgery to clean out some of my meniscus (10% SC for arthritis, didn't know you could claim meniscus separately but will put in for it.)

3. Shoulder surgery (VA denied and diagnosed shoulder strain, well I am going to fight that one with them as it is now diagnosed as arthritis, separation and R/C.)

4. Cervical neck surgery ( based off of the Ortho doc's opinion, and my Primary's.)

Which to do first...? I put in a claim for my neck, received the Notice to Assist, will send it back asking for more time to gather my "evidence" ( doc write-ups, MRI's and Radiologist's Report ). My VSO is waiting for my EMG results to fight my CTS denial, the Ortho and PT report to fight the shoulder denial. I am so fricken' confused on what to do...I am coming up on my 1-year post retirement date. I don't want to take the damn "shot-gun approach, but several of my doc's have said that I have a multitude of problems that I should of had addressed while I was on Active Duty and are amazed that I made it this far before bitching about the pain.

HELP!!!

Monster

Hey Monster, Talk about aches and pains! I can only imagine how uncomfortable you are. I have had each of the procedures you mentioned, just not all at once. I know I've had over a dozen epidural steroid injections just on the lumbar region alone. Had the left knee "cleaned out", both rotator cuffs repaired, 5 cervical fusions surgeries and 4 lumbar. Thats not all, but it's enough to let you know that I can relate to your pain. As far as what to do first, I would determine, with a doctors advice which problem can suffer the most damage by waiting. For instance, my Dad waited too long before having his shoulder repair so after he did have the surgery he was not able to get alot of his function back. The surgeon told him the tendon was heavily damage due to him waiting. Also if the nerve in your neck is being compressed in certain ways it can result in permenant damage. Not always the case but often is. It's possible that you could get quick relief from the lumbar shot. You want know till you do it.

My advice is to ask a trusted doctor just what he recommends and charge ahead! I hope you will be able to get some relief soon! Check out the surgeons you are considering. You want the best you can get! It's like anything else, there are good ones and bad ones.

Blackbird

[My Monster]

Thank you Blackbird! I am trying to figure out how to get fixed, what denials from the VA to fight, what is a legitimate claim, and how to claim it. I am against narcotics for pain management, I have a huge tolerance for pain ( which scares me and my doc's ), and anything (meds-wise) only works for a couple of weeks before my body adjusts to it. After talking to my doc's I am beginning to think I truly am the odd-ball patient. LOL

Monster

[My Monster]

any other input on this? I am feeling about hopeless...

[Pete53]

Good Luck I am praying for your win.

[SLEDGE]

When talking about nerves you have to consider one thing first,

is one problem causing or hiding another?

It takes a specialist to figure it out and opine as to which

problem needs to be adressed first.

Getting my neck fixed affected several other conditions below

the neck.

Doc said that nothing (diagnosis) can be trusted downstream

from any nerve involvement.

Dang near everything is downstream from the cervical area.

sledge

[My Monster]

I just got the write up from the doc. Last page states:

"HE HAS MULTIPLE OTHER PROBLEMS, KNEE, NECK, AND LUMBAR. HE WILL DECIDE WHICH TO TAKE CARE OF FIRST.

HIS ROT CUFF PROBLEM IS LONG STANDING FROM HIS MILITARY DAYS. HIS CURRENT CONDITION IS CONSISTENT WITH AN OVERUSE TYPE PROBLEM SUCH AS PHYSICAL ACTIVITY ASSOCIATED WITH ACTIVE DUTY."

Generalized swelling of the shoulder. Mild crepitation of the subacromial joint. Trigger point present.

ROM: active forward flexion of 0-90, pain elicited with active flexion.

active abduction of 0-60, active abduction of 0-90, pain elicited.

active internal rotation of 0-45 with pain.

active external rotation of 0-45 with pain.

Positive crossover sign. Positive Hawkins sign. Positive impingement sign.

Generalized mild tenderness over the neck and shoulder girdle, generalized moderate tenderness over neck and shoulder girdle. Head held in a forward position, straightened cervical spine. Movement mildly restricted in all directions, movement restricted in all directions, pain elicited in all directions.

x-rays findings: overhanging Acromian.

impression: rotator cuff synd shldr and allied d/o

SO...I have an MRI for my neck Weds. Neurologist appt the following Weds. Seems like the doc's and therapist is in concurrence that I need my neck fixed first, I need to get better ROM in my shoulder before they repair it and that I am a walking mess.

I am looking to file a claim for arthritis, separation and torn rotator cuff of the right shoulder. I think is Nexus letter will support that, along with PT's write up. Cervical arthritis, and whatever the nerve study tells me in 2 weeks, but it looks like that will be a bi-lateral factor as it effects both arms and more importantly my hands. Tremors suck. This just gets more depressing as the hours go by.

Thanks all for the input.

Monster