The Broken Soldier

Had my first ortho appointment this week.  Toon’s clinic.  Bad memories.  Big concerns about going there again.  My concerns were justified.

The man conducting the exam was a captain.  I assumed he was a doctor, though I did find it strange that during the exam he kept referring to print-offs with lumbar and sacral spinal nerve dermatomes.  I later found the man was a nurse.  My orthopedic exam, which will in part determine future care and possibly a disability rating, was performed by a nurse.  A nurse!

Don’t get me wrong, I harbor no prejudice towards nurses or nursing.  Actually, had the man gotten things right I wouldn’t have bothered mentioning his station.  But he didn’t get things right.  Not by a long shot.

I have burning sensations in my feet.  His dad has burning sensations in his feet.  My mom has MS.  His dad has MS too.  Therefore I may have MS.  Got two words: Occam’s Razor.  Or for my nerdier readers (or assholes who write editorials for major print media sources and like using words their audiences probably won’t understand), lex parsimoniae: Entia non sunt multiplicanda praeter nessitatum. 

I have sensation in my legs and feet.  I can distinguish sharp from dull.  Therefore I don’t have radiculopathy or any other peripheral nerve neuropathy or neuritis.

Absent plantar reflex.  That’s new by the way.  Therefore central nervous system rather than peripheral.  In other words, my deficits aren’t related to my injuries.

Now let me tell you what’s really happening.  L5-S1 nerve entrapment revealed by MRIs, contrast dye CT scans, discogram, and confirmed by EMG.  Higher lumbar levels degeneration revealed by MRI.  Depressed or absent achilles bilaterally.  Depressed right side patellar.  Hyper-reflexive left patellar.  Absent plantar.  Burning sensation in both feet.  Pain from low back (bilateral) to right hip, butt, outside right leg to the middle of my calf.  Motor deficits in right lateral toes (dorsiflexion) and right foot (also dorsiflexion).  Guess what can cause those symptoms?  Damage to spinal nerves (peripheral nerves) from lower thoracic to upper sacral.

That he got things wrong isn’t what concerns me.  An honest mistake and a willingness to admit it can be easily enough corrected.  But at one point in the exam the man grabbed me by the arm stating, “Don’t lie to me.”  At that point I wasn’t quite sure how to respond.  Communicating the possiblity of an error is difficult with a medical professional who assumes you’re lying.  So I didn’t bother communicating with him.  I thanked him, shook his hand, and immediately went to my chain of command (who were very supportive).

Today I met with my case manager.  She stated there’s no reason for me to go back to him, but if one comes up, and this sort of thing continues, I’m free to request someone else, file a complaint, etc.  That’s good to know.  While it’s unlikely the medical problems I have can be fully healed, it is certainly possible that I could be further injured - either by improper care or improperly being cleared to return to duty.  I’ll be sure to keep you posted of any further developments.