Wednesday, February 22, 2012

Masterful Understatement

I took my mother to see an orthopedic surgeon yesterday.  

In January 2011 she started some serious complaining about pain.  First there was the gout -- in her toe, later in her thumb.  Now she takes a daily anti-gout pill.  Then there was the shoulder pain that had her right arm in a sling for about 3 days -- until it was too much trouble to keep it in the sling.  She had been complaining to her primary care physician for at least a year before that about her shoulder bothering her.  She is correct when she says he doesn't really listen to how she feels about things, just passes her complaints off as the normal process of aging.

At her January 2012 quarterly visit with the PCP, she was offered an x-ray and a visit to the orthopedist.  She declined, complaining, "Can't you just give me a shot and make it go away?"

By last week, she was no longer sleeping because the pain was keeping her awake at night.  After another visit to the PCP, she agreed to shoulder x-rays.  Initial diagnosis?  Worn out shoulder joint with rough places, bone spurs in the space where the shoulder and scapula meet, and possible rotator cuff damage.

The orthopedist took one look at the x-rays yesterday, blew by the worn out joint and bone spurs, and focused directly on that rotator cuff.  "No question." he told his nurse.  "That rotator cuff is completely separated from the bone."  Patiently, he explained her options to my mother.  1) Live with it.  2) Get a cortisone shot that might reduce the symptoms, typically for about 4  months, then repeating the shots as necessary.  3) Surgery to smooth out the rough places on the bone that are rubbing together and causing the pain.

My mom elected not to have surgery, but admitted that the pain is more than she is willing to continiue to endure.  That left the shot option.  With a little help from her daily doses of  ibuprofen, today the pain is down to an acceptable level.

Here's the kicker.  Before seeing the orthopedist, she had to fill out a basic new patient form.  Do you have pain? Yes.  Is it mild, moderate or severe?  Mild.  On a scale of  0 to 10 where 0 is no pain and 10 is the most you can stand, what is your pain level?  9.  I warned the receptionist.  "This lady won't complain.  The fact that she is here says the pain is more than she can tolerate.  Keep that in mind when she describes it as mild."    They smiled and said they'd bring that to the doctor's attention.

Give thanks for competent doctors who take the time to explain to each patient all their options and the consequences of each, then accept the patient's decision for treatment.
Don't forget to pray!