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Wednesday, August 24, 2011

Not Good

Okay, it's well past midnight, and I really shouldn't start writing so late, but I wanted to record this while still fresh in my memory.

If you've been following my blog for a while, you know we've been dealing with some ongoing health issues with my husband.  Some of this includes old injuries coming back to haunt him, and the worst of these is his back.  He tore out the muscles on one side of his lower back twice - the first time while in the military some 20 years ago, the second time during martial arts training almost 15 years ago.  That second time never really went away, and it's gotten increasingly worse in the last few years.  Despite numerous doctors visits, Xrays, and other examinations, it was only last year that we found out that he also has spina bifida occulta, and that a couple of his vertebra aren't attached properly.  Basically, he's in pain pretty much all the time, though the severity of it comes and goes.

Last night, however, took it to a whole new level.  We don't even know what triggered it. 

For the past while, he's been missing a fair bit of work and he's often called me to give him a ride home from work early.  He usually walks to work, which is supposed to be good for his back, but it hasn't seemed to be helping at all lately.  He'd missed Friday last week because he could barely move, tried to go to work on Monday but called for a ride a couple of hours early.  He was walking with a cane again, and had difficulties just getting into the van.  He has his muscle relaxants, which help but make him sleepy.  Loopy, too, if he has to take more than one, so he doesn't take them while at work. 

For some reason, however, the area started spasming far worse than he's ever had before.  I had got up at about 5 am, having given up on sleeping by then, and was in the kitchen making breakfast when I started hearing him moving around.  He was clearly having troubles, from the sounds I was hearing, and I was really startled by some rather loud sounds I couldn't figure out.  It turned out that he was simply trying to get out of bed to go to the washroom.  It hurt so much to move, he had difficulty getting just rolling over, never mind crawling out of bed and having to crawl around to find something he could use to pull himself upright.  Then when he tried to use the washroom, the loud noise I heard was him falling onto the toilet (not off, thankfully).  When he came downstairs, I could hear him struggling with every step he took.  Rather alarmed, I asked what was happening with his back and he told me that the only thing keeping him from screaming in pain was the fact that the kids were asleep. 

He spent the next while pacing from one end of the house to the other, trying to work out the spasm.  Walking is one of the few things that helps.  He took a double dose of his muscle relaxants, but he wasn't sure if they were any help at all this time.  He would only keep walking for so long before he had to sit for a while, but the act of sitting down was incredibly painful.  I'd set up an electric heating pad for him to use, but he kept having to shift around from the pain, I don't know that it even had a chance to be any help.  He'd then have to get up and walk some more, with getting up being just as painful as trying to sit down.  We even debated whether or not to take him to the emergency, but decided against it.  Instead, we decided to get him in to see our regular doctor as soon as possible. 

We both finally tried to go back to bed for a couple of hours before the clinic opened.  Well, couch for me, as the hard mattress he needs for his back is too hard for me to sleep on.  We got a bit of sleep, at least, but even with the muscle relaxants and painkillers, his back wasn't any better.  It got to the point that he dreaded any kind of movement.  I understand only too well, from when we were living in Richmond and my osteoarthritis let me know it was there.  I still remember being almost in tears just thinking of how much pain I would be in when I stood up, yet not having a choice.  Knowing that moving around would actually help reduce the pain a bit didn't make that initial pain from getting up any easier to deal with.  At least I could sit up on the side of the bed before I had to deal with the pain.  For him, it starts with the very first movement.

He called the clinic shortly after it opened, and they were able to make an appointment for him at 11:30.  He spent much of that time in our computer chair, which has the most lumbar support, and also allows him to recline if necessary.  It's also much easier to get in an out of than any other chair we've got.  Even so, he was constantly squirming around, and would have to get up and pace every now and then.

When it was time to leave, I brought the van around so he wouldn't have to walk as far.  Getting into the van was a challenge.  He would get one leg in and be sitting down, but had to make several attempts to get his other leg in.  Even closing the door and buckling up had him struggling.  At the clinic, I was able to drop him off pretty much at the door (though 2 cars were parked in the loading zone, so it wasn't as close as it should have been).  I was able to find a parking spot fairly quickly, so it was only a couple of minutes before I could join him.  I remember glancing at the clock and seeing we were 10 minutes early.  At pretty much the same time, I could hear the receptionist telling someone that they could take Dh into an examination room.  Dh's name was then called by a young man I'd never seen there before.  Dh mentioned hearing that he was the son of one of the receptionists, so I don't know if he even actually worked there, or was just volunteering to help out. 

We followed him down the hall and he showed us to a room.  He seemed a bit hesitant about it, pushing the door open to see if anyone was inside, or at least so it seemed to me.  He carried no file, though.  The last time I saw our doctor, they were just moving back into this building.  The building the medical files had been stored in during the move had flood damage, and they were slowly going through all the folders to transfer them to electronic files.  This was a problem with some of the more badly damaged files, but ours were not among those.  At the time, the Dr. was still having to do everything on paper and by hand, but not anymore.

We didn't have to wait long before the Dr. came in.  He's seen Dh often enough to remember most of his issues off hand.  It was while he was describing the spasms to the doctor that I found out just how much worse than usual it was.  Normally, the injury area itself spasms, which also affects the surrounding area, but still mostly just his lower back.  This time, the spasms were shooting down through most of his leg as well. 

As we were talking, the Dr. glanced at the computer screen and noted that Dh hadn't had any Xrays done.  Dh mentioned that he had, and that was when we'd discovered the other problems with his spine. It reminded us to ask for the release the physiotherapist had asked for, so he could see the test results before attempting any more treatments.  It kept getting forgotten, so Dh hasn't been back for physio since then.  The Dr. scrolled up and found the test results and printed the page off.  He also wrote up a chit for medical leave for Dh.  He was willing to write him up for a couple of weeks or more, but Dh has lost a job over extended medical leave in the past, and he didn't want to risk that again, so he got written up for just this week.  The Dr. printed that off, too.  He also wrote Dh up for an MRI to check for nerve damage and see if there's anything that can be surgically repaired (which was ruled out a year or so ago, but it worth looking into again).  A bit more discussion of treatment and pain medication (the T3's I never used from my own surgery are now going to see some use), and we were done.  On the way out, the Dr. grabbed the printouts for Dh, who just folded them up with barely a glance. 

Yes, that detail is pertinent.

As soon as we got home, Dh scanned the note for medical leave and emailed it in to work.  Once he was safely ensconced in the computer chair, Youngest and I headed out for some errands.  Dh was in bed when we finally got back, but he got up soon after.  Once he was up, he took the computer chair again and checked his email.

Oh, oh.

There was a problem with his medical leave.  It turns out there was someone else's name on it.


The sheet was still in the scanner, so Dh took it and looked.  Everything was exactly as it should have been - a brief description of the problem, the length of time off, the Dr's info at the top and...

Who's name was that on the other side? 

Thinking it might just be a problem with the medical leave, I checked the printout of his test results.  Sure enough, there was this other person's name.  Reading the results, though, it looked right.  The specific vertebra that were damaged listed and... hold on.  It doesn't say spina bifida occulta.  It names a different type of spinal damage.  What the heck?

Some how, instead of Dh's file on the computer, the Dr. had someone else's file, and this someone else has problems just close enough to Dh's that the Dr. didn't notice.  We couldn't see the name on the screen and when Dh got the printout, it never occurred to him to double check for his own name.

Which means that this other person now has new notes on his file that should actually be on Dh's file, has been written up for a week of medical leave, and has a request for an MRI sent out.

Not sure what Dh has been written up for that was meant for the other guy.

In talking it over, the only thing we can think of is that the person who lead us to the examination room took us to the wrong room.  The Dr. likely sees far too many patients to remember all their names off hand, and would have had no reason to think that the file on his computer was for someone else.  That there would be another patient there at the same time with similar enough problems, and who *also* had testing on his back done about a year ago, would have been pure chance. 

Which means we need to get back to the clinic first thing tomorrow and get this fixed.  It's a relatively minor problem for us, but potentially a huge problem for them.

Not good.

Which also means I need to get to bed and try and get at least a few hours sleep. Tomorrow as the makings of another very long day.

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