Monday, March 21, 2011

Why I Love My Job

Some days it's just incredible how life sets gifts on your door.

Today I had a patient in his forties who has been suffering from back pain since a motorcycle wreck 17 years ago. We all know people who were hurt in a wreck or other accident when we were in high school. This still young man had been living with back pain for two decades. He had had three back surgeries, one of which didn't take.

He came to my clinic, able to walk, but in severe, activity-limiting daily pain. He has fractures that were overlooked by other doctors. There are two main reasons why.

First, they were very mild fractures on x-ray and MRI. Most of the spine surgeons I work with would blow them off. Yes, they are subtle and they are mild, but they do not look like normal vertebrae. Personally, I used to blow them off too, because that is the standard of care and that is how I was trained. However, that is not the right thing for the patient--we'll come back to that.

The other problem that these types of patients encounter is that their fracture is remote. I heard from self-proclaimed expert spine surgeons all the time that fractures don't respond to vertebroplasty after 6 months. Really? These opinions are usually most vehemently held by the surgeons that don't even perform vertebroplasty. So they have zero clinical experience with a procedure that cures pain from vertebral compression fractures in 95% of patients.

I guess if I had trained in 1970s or 80s, that I might be in the same boat. However, doctors are supposed to be patient advocates. We have to do the best thing for our patients. And because I perform hundreds of vertebral fractures each year, I see those who were blown off by other docs. True, some of them aren't painful. But most of the ones are. Sometimes it is the subtle finding that is the only imaging indication of a big problem.

So, the young man in question. When I see him in clinic, I spend 20 minutes going over the subtleties of his situation and why other doctors haven't been able to help him. I also tell him that he has a greater than 80% chance of being pain free after vertebroplasty.

Today we fixed the fracture. Afterwards, he got up, went through all the range of motion exercises that usually cause him pain. He said his pain was gone.

It makes me very sad to think that this young man had to suffer for all of those years. Granted, vertebroplasty has only been around in Tulsa for about 10 years. But even 10 years is too long to suffer when it isn't necessary.

I really feel for those patients out there who suffer from back pain day to day and haven't found the solution, because sometimes it is that easy. But it really gives me indescribable joy when I can help another human like this end decades of suffering. Giving hope to the hopeless is what I love doing--and I am lucky to be able to do it everyday.

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