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Author Topic: Opting out of surgery a bad idea?  (Read 649 times)

Vicki D

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Opting out of surgery a bad idea?
« on: August 07, 2017, 11:22:02 AM »
Hello everyone. New member here. Been reading for a while but this is my first post. I feel so blessed I found you folks! Iím waiting for a hearing date-been 9 mos now and I hired an attorney after being denied at Reconsideration. You can see my conditions below (hope I got the format correct) and my question is regarding a recommended surgery.

About me: Worked all my life, raised my 2 children by myself and in 2015 my unemployment benefits ran out. Even though itís a great financial burden for him, my wonderful son (a former US Marine) took me in and I moved to San Diego to share a one bedroom apartment with my son, his wife and her 9 year old daughter.

Lack of finances made it so I could only take what I could fit in my car-no exaggeration here. Had to give away my 2 precious kitties and leave behind a lifetime of possessions I had worked hard for. ALL my furniture, appliances, dishes, clothes-you get the picture. It was the most traumatic thing that has ever happened to me. And even though I help out as much as I can my DIL does not want me here and has made that very clear even calling me an "invader". Iíve lost all dignity and sense of self-worth, feel so ashamed and very, very depressed. I cry all the time still even after 2Ĺ years. Honestly no matter where Iím at Iíll think of something and start crying. And as most of us here, I truly wish with all my heart I COULD work so I could have a place of my own again. I now spend most of my time trying to stay out of their way staying in a curtained off section of the bedroom on a twin bed, with a nightstand and a little bookcase. Oh and in 2016 my car was stolen. They found it 4 mos later, damaged. I do feel fortunate still that my son could have the car fixed and I don't have to live in it yet.

My insurance is the state provided kind for which I am very grateful, especially since Iím on 13 meds, but I get the feeling I donít always get to see the best doctors. I was sent to a neurosurgeon who shared an office with his dad and another doctor. The office was rundown and shabby and honestly so was the doctor. I found out later the handwritten medical report was all they had since they ďdonít do anything electronicallyĒ. And when I went to the restroom I overheard him pressuring a reluctant patient to have surgery.

At first, although I didnít notice anything odd, he said I have an excessive reaction to the knee jerk test (the one with the little hammer) and wants me to have a brain scan. (??!?). For my back, he recommended a laminectomy: creates space by removing the back part of the vertebra that covers your spinal canal, also known as decompression surgery. What was NOT on the report were his verbal comments: as a result of the surgery I could be trading one kind of pain for another, it could do nothing at all or could make it worse. All that and not having heard of even one successful back surgery I told him Iíd think about it.

Related all this to my attorney who said the judge canít legally hold it against me if I decline an invasive procedure and that I would have a chance to explain to the judge about the doctorís written vs. verbal comments.
1-Iím still VERY worried this could be held against me. Isnít it like asking a jury to disregard something theyíve heard?
2-I think my insurance would cover a second opinion. Do you think itís worth pursuing that or would it makes things worse of doc #2 agrees with doc #1 but I still don't want my spinal canal permanently exposed?

Would very much appreciate your thoughts on this. Thank you !!!
Name: Vicki
Location: California
Age at Application: 58
Disability: Back: epidural lipomas, severe central canal stenosis, degenerative disc disease, arthritis, anterolisthesis, scoliosis, bulging discs, severe thecal sac compression, type 2 diabetes, peripheral artery disease in both feet, metabolic syndrome, abdominal hernia, sleep apnea, overactive bladder.
Date Applied: 01/08/16
First Denial: 04/12/16
Reconsideration filed: 04/29/16 Denied on 08/24/16
Request for hearing filed: 09/16/16


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Re: Opting out of surgery a bad idea?
« Reply #1 on: August 07, 2017, 12:10:29 PM »
Definitely get a second opinion before you have any kind of non-emergency major surgery.  Obviously, if you have appendicitis for example, you don't have time to go see multiple surgeons.  But for planned back surgery, definitely get 2 - if not 3 - opinions.  And research who the best surgeons are in your area.  I think you should read SSA's policy on Failure to Follow Prescribed Treatment.  If the treatment is not reasonably expected to restore ability to work, you do not need to do it.  Also read section 3 on Good cause.


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Re: Opting out of surgery a bad idea?
« Reply #2 on: August 07, 2017, 01:00:51 PM »
Just an FYI on something I ran across the other day while looking for my cardio's surgery credentials.  Not sure if we are allowed to post links, but you can check certification of the doctor that is performing your surgery, or wants to, at the Board of Surgeons website. 

I will go ahead an post the link and if it's not allowed, I totally understand.  (click the box that says "For the Public")

Vicki D

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Re: Opting out of surgery a bad idea?
« Reply #3 on: August 07, 2017, 01:45:36 PM »
Thank you both. I will definately take your advice.


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Re: Opting out of surgery a bad idea?
« Reply #4 on: August 07, 2017, 05:26:29 PM »
Hang in there Vicki, things will get better! I will pray for you.

Vicki D

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Re: Opting out of surgery a bad idea?
« Reply #5 on: August 08, 2017, 03:47:55 PM »
Thank you. I know the Good Lord has a plan I just hope my road smooths out a bit up ahead.


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Re: Opting out of surgery a bad idea?
« Reply #6 on: August 08, 2017, 08:06:27 PM »
 :Welcome08:  Hang in there I'm sorry you had to give up so much.  As far as 2nd opinion definitely.  I had 4  opinions before my surgery at 59.  My mother is having laminectomy tomorrow and she is 86 but her stenosis is so bad they have to release the pressure.  Certainly don't wait as long as she did since the older you get the more risky.


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Re: Opting out of surgery a bad idea?
« Reply #7 on: August 13, 2017, 08:50:35 AM »
Hi there,
I was recently told about a procedure called plasma rich platelet therapy, where they take your own blood and spin it in a centrifuge to sperate out the platelets and then inject them into the area of the back that is injured.
From what I understand the platelets repair the damaged section much faster since the spine itself does not get as much blood flow as other parts of your body.
Now I don't know if this can help you with your situation, but it could be something to look into - I know I am considering that from my damaged disks in the lumbar section  of my back as I am not willing to risk having another failed surgery and adding more pain to what I already have. Kinda of like sleeping with the Devil you know that the Deil you don't.

Best of luck to you, I hope things get easier for you and your DIL learns to relax a bit.
Paul :-)
Life is 10% what happens to you and 90% of how you react to it


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Re: Opting out of surgery a bad idea?
« Reply #8 on: August 13, 2017, 09:49:08 AM »
Sorry you are having such a bad time.  This is a long and stressful battle. 

As far as the surgery, I would definitely get a second opinion before having the surgery, especially as you are uncomfortable with the doctor.  The ALJ is not supposed to hold not having surgery against you.  They look for non-compliance with therapy, medication, tests, lifestyle (example if the doctor told you to stop smoking and you continue to smoke, or not doing recommended excercises) etc..

Good luck to you


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Re: Opting out of surgery a bad idea?
« Reply #9 on: August 14, 2017, 06:27:44 PM »
 This is not related yet.... I was approved for SSDI 2013 for spinal issues, as an aside on my application I had listed high blood pressure and aortic stenosis as minor also being treated for issues.

 Fast forward to November 2016, having trouble breathing at night, loss of energy and stamina during the day, can no longer walk for weight loss and spine health.
 July 5, 2017, had open heart surgery to replace my aortic valve which entailed cash out of pocket 1180.00 in co-pays pre and post op and 1450.00 in dental work (risk of heart infection, surgeon said pull my teeth and get dentures)

 Kaiser waived my 275.00 per day times four days hospital surgery bill, I filled out financial aid paperwork so that was helpful.

So now Kaiser has referred me to the local hospital for top notch cardiac rehab program at 25.00 per visit copay and 36 visits plus around 150.00 gas.

 Extensive testing - and for open-heart surgery you have every test and imaging study there is- revealed minor COPD so my prescription costs have doubled per month.

 I have again filed for financial aid for prescription and cardiac rehab co-pays but the reality is I make a few hundred bucks too much per month and do not qualify for food stamps, electric bill help, extra help from Medicare or anything and believe me I have spent hours looking. I am sole support for the spouse(and her medical issues) my home (living expenses bare bone) Etc...

So I guess I am not going to cardiac rehab and have to cancel my 50.00 per month inhaler prescription. I cannot afford these treatments, I still have regular cardiac doctor visits and several PCP visits I must attend over the next few months, along with the usual prescriptions I must fill.

 I'm further confused as to why Kaiser and my army of  Kaiser doctors are hot and bothered to get me into physical therapy when I was turned down twice by Kaiser physical therapists because of my spine /inability to walk far and exercise let alone sit and stand for meaningful periods of time.

 This will be my first failure to follow treatment, although not directly related to my SSDI approval. Money is a huge issue when it comes to medical treatment.

 In early 2015 I was forced to use the food bank while undergoing X-Rays, and 13 specialist and MD visits plus Pain Management classes in order to get a Norco prescription continued from my previous state I lived in.


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