Neurology dept. not responding to messages re: MRI results.

Posted by upnort @upnort, Oct 12 11:12pm

It has been over 2 weeks since my latest MRI (progressive thoracic myelopathy). I have messaged my neurologist through my patient portal, called his office and left messages with his staff to call or message me to discuss the latest MRI results and where we go from here with my Mayo Clinic health care plan (Rochester, MN). I was told last week someone would contact me. No communication to date. Mayo Clinic is my lifeline - I have no other specialst to turn to (I live in a rural community in northern Wisconsin), and I have been a Mayo Clinic patient for 6 years. Do I need a health care advocate? Would Mayo Clinic patient services help me?
What about my rights and responsibilites as a patient in the Mayo Clinic Health Care Patient Bill of Rights? I feel abandoned by the health care system in general and by Mayo Clinic's Neurology Department specifically. Any suggestions from fellow Mayo patients would be greatly appreciated.

Interested in more discussions like this? Go to the Spine Health Support Group.

Profile picture for laura1970 @laura1970

@jenniferhunter there is, in the coming months, going to be the first human spinal cord transplant in Israel. The animal studies were very promising. 54% of mice with total transaction of spinal cord were able to ambulate pot surgery. This new technology probably will only benefit the next generation but I’m so glad the research is being done

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@laura1970 Wow, that is news! I think back to the spinal cord injury to actor Christopher Reeve, and in the years that he lived after the injury, he was able to get off the ventilator for periods of time and walk a little bit in a pool with the water holding him up, so that may represent very slow healing.

Thanks for sharing that news. I found an article that describes creating tissue with stem cells to replace a damaged area of the spinal cord. They will remove the damaged area which has scar tissue in it and put in its place bio-engineered tissue created from the patient. This sounds a lot like the research done at Mayo where Dr. Bydon was able to restore function to a patient with a severe spinal cord injury from surf board accident. Not every patient in the study had a good response, but this one patient did and walked again. Here is the story about Israel. FYI, Dr. Mohamed Bydon is currently working at the University of Chicago.
https://www.aftau.org/news_item/surgeons-to-implant-spinal-cord-bioengineered-at-tau/

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Profile picture for Jennifer, Volunteer Mentor @jenniferhunter

@upnort I do understand your concerns. I am a spine surgery patient and I have learned a lot through my own advocacy and my science background. One way to find information is to look up the findings of the imaging report online and see if you find anything. There are videos online from spine conferences where cases are discussed and some can be accessed for free; others are limited to members of an organization. I learned a lot that way. If you look at your imaging, you can try to find the problem. Myelopathy on an MRI looks like a whitish area that is often diffuse in appearance. When you see that, it is because those nerve cells are missing. Generally speaking, the spinal cord is very limited in ability to heal, and myelopathy may be a permanent loss of function of that part of the spinal cord. There is always research being done, and there has been some success in recovery from serious spinal cord injuries done at Mayo. There has also been an apparatus that has been able to bridge the gap to send signals past a damaged area of the spinal cord to help a patient walk again.

I can’t answer what options may be available to you, but in serious cases, that is some of the work being done. Hopefully, I haven’t made you worry unnecessary. You do need an expert to interpret your results.

Can you share what the findings say on your report?

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@upnort I did look at the report findings from your imaging that you sent privately. I am responding here so that others may benefit from the post.

I don't know how long it has been since your doctor referred this to a neurosurgeon, but there is enough in the report that you may benefit by seeking an opinion of a neurosurgeon. Physical therapy is not going to able to fix nerve compression in your spinal column. There are structural problems, and your report may be indicating bruising of the spinal cord with the myelopathy in the thoracic levels. The spinal cord needs to move inside the fluid in the spinal canal, and if any part of it is tethered by pressure from stenosis on the spinal canal, that wouldn't be a good situation. One of the complications of having thoracic spine issues is that these levels have ribs attached and your lungs are right there inside the ribs. The surgeons who are able to operate on thoracic levels are usually the surgeons who do big scoliosis and spine deformity cases. Not all spine surgeons would operate on thoracic levels. I don't know if you also have other issues at other spine levels such as cervical. There are always other considerations of operating on an older person which includes osteoporosis and general health and an ability to heal. There are a lot of end plate changes and discs shrinking which causes wear and tear on facet joints on your report as well as indenting of the thecal sac which would be a condition that may put pressure on the spinal cord. There are also some issues with arthritis in the foramen where nerves come out from the spinal cord. I don't know if you have had spinal injuries, but some of this is age related that tends to be common in seniors.

As a bit of hope that I could share with you, is a member we had on Connect, Robert Hodes who's member name is @hodinator. I communicated with him a lot and he had spinal cord compression and was in a wheelchair unable to walk for several years. He had spine surgery and with a lot of rehab, he did walk again. I don't think he has been on Connect since his recovery, but his story is inspiring because without Connect, he would not have understood the issues. Being on Connect also helped him find a good surgeon closer to his home. He made the biggest recovery of any of the patients I know on here. If you click on his name, you can find his posts under his profile.

My suggestion would be to contact Mayo and ask that your imaging and report be reviewed by Jeremy Fogelson who was my spine surgeon. He is a deformity expert and he does a lot of big surgeries for scoliosis. He is well respected there and an excellent surgeon.

I know you have a lot on your plate with taking care of your wife. Being a caregiver is a hard job, and I did that for my dad when I was in need of spine surgery and in a lot of pain. I had trouble getting a surgeon to help me until I got to Mayo to Dr. Fogelson. Bless you for doing that. I do hope you have some help from time to time so you can rest a bit.

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@upnort, I'm just catching up with this conversation. @jenniferhunter has been kind in offering an intepretation and information about the spine. However, we are fellow patients. As you have rightly recognized, you want to discuss this with your neurologist who has the benefit of your MRI results as well as your complete medical history and other imaging.

@johnbishop's suggestion of contacting the Office of Patient Experience is a good one. I suggest calling the Neurology office, the staff person who said you would be hearing from them.

I understand your fear and anxiety. Every day your symptoms continue their downward spiral and you want answers or, at the very least, to know what to do next. I can imagine that each passing day feels like an eternity. Call them tomorrow.

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@upnort, checking in. Did you get in touch with someone?

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The neurosurgery department left a voice mail this afternoon. I am supposed to contact them tomorrow. I still haven't gotten a response from Dr. Flanagan, my neurologist. The lack of communication between patient and doctor is unacceptable under any circumstance. I am extremely disappointed in Dr. Flanagan, the neurology department, and Mayo Clinic. I will be contacting the office of patient experience.

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