Wednesday, April 1, 2009

Day 108 - Physical Therapy? Soon!

Jan had her second visit with the doctor today and, as usual, a simple thing is over six hours. That's the worst of it. The good news is she can take the collar off any time she wants. The doctor said she needs to wean off of it, probably within two to four weeks. At that time, she can start physical therapy. Her next appointment is not until July 1 when he, hopefully, will declare her cured and free do as she pleases.

For those that wish more details, they follow. We left at 12:30PM, arrived at the hospital by 1:45PM for a 2:30PM appointment. At all of the old appointments with the neurosurgery clinic, she had to go to the imaging lab at the main hospital by shuttle and then always to the OTHER IMAGINING LAB because they were backed up and then back to the neurosurgery clinic. Minimum of one hour both times plus all the hassle of getting a halo patient into and out of a van twice.

This time, we stopped at the imaging lab at the children's hospital ground floor, since we are trained to do that by the old clinic. She registered at the imaging lab at 1:50PM. The orders were not in the system so the check-in person called up to the doctor's office and they faxed them down. We waited 20 minutes and they said they were faxing them down but they never arrived. The guy finally went up to the ninth floor and got them. It was now 2:15PM.

The guy returned with the orders for imaging in his hands and put Jan in the queue. That took another 20 minutes and she was now officially late for her appointment. When she got back to the x-ray room, it didn't say if the collar needed to be on or off. They called the office but didn't get the doctor. They paged him and it took another 10 minutes. He called back and said to take it off. Jan didn't feel comfortable standing unassisted without it so the tech put me in a lead apron and I held her hands. She had to hold her head normally then bend her head forward and backward for x-rays of each view. She got through it fine if a little shaky.

We arrived on the ninth floor a good 45 minutes late for the appointment but still sat another 30 minutes in the waiting area. Once in an exam room, we spoke with the physician's assistant, the one that actually told me that the nurse practitioner canceled the appointment and she had scheduled Jan back with the neurosurgeon. Boy, was she honest and enlightening!

I won't spill all the details but suffice to say the NP rejected Jan's appointment and the PA promptly took ownership of the case and things have been so much better. She listened to the horror stories about the halo installation, the poor fit and the lack of support from the neurosurgery clinic. She said she took over Jan's case now and it would certainly be a better experience. So far, she has been dead on. The PA also told us she would brief the doctor on the issues before meeting with Jan and me and that we should tell him as well since he is an assistant professor at the hospital.

When the doctor arrived, we were fairly sure he was briefed but he played it very professionally, saying he would follow up on our issues and that she was past that portion. He said it would only get better from now on. She can't drive yet until the collar comes off and she can look to her sides and her weight limit is just 10 pounds but she is basically free of the collar when she has the confidence to take it off.

The tingling in her leg is a pinched nerve, caused by the vest. The doctor said it was much like a bruise. With luck, it will resolve within a few weeks or months. The pin holes are healed but still noticeably deep. He does not believe they will change much other than the pinkness of the skin turning whiter. I think she should at least consult someone about reconstruction to at least lessen them. After all, her forehead was fine after the accident and they are the ones that scarred her, physically and mentally.

After reviewing her x-rays with us, he said it looked very good. He said she would not need surgery, would not be paralyzed and there was no danger of her damaging the bones in her neck. According to him, it is healed well enough. The bones will remodel for some time but the strength is good enough to have no reservations.

He said she could take the collar off any time she wanted and encouraged me to help her wean off of it. Jan has the prescription for physical therapy now and can start in as little as two weeks but should be completely out of the collar in four weeks. PT could last as much as six weeks, depending on progress.

We left the office right about 6:00 PM and arrived back home just after 7:00 PM. A long day but overall, it was a good visit. Jan broke down a bit while detailing the trials she, and I by proxy had been subjected to through the previous months. If only she could have seen him from the beginning, things would have been so much better, possibly even tolerable.

Posts from here on will probably be fewer unless there is a funny redneck story to tell. I will continue to update on significant items as they occur but I think the worst is definitely behind us.

2 comments:

  1. It sounds like the worst is definately behind you. It`s good that she is getting physiotherapy. My doctor did not prescribe any for me for the time-being. He thinks my range will improve on its own in the next few weeks. I see my own GP at the end of the month so if there is not much progress I will talk to her about physiotherapy. If Jan is nervous about removing the collar, she might start by just trying to sleep without it. That`s what I have done. It`s more comfortable, but it does make for a sore neck the next morning. I guess that`s to be expected. Best of luck. Hope everything goes well for you both from this point on.

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  2. I hope the worst is behind us. I will not let go of the anger I feel toward the others that subjected her to the undue pain and suffering, though. It reminds me to be vigilant against those that have no business providing care in this field.

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