C7-T1 Radiculopathy Laminectomy Mayo Rejection

Posted by christ @christ, Dec 30, 2020

Hello, I underwent a C7-T1 laminectomy in March 2020 and continue to experience neck and arm pain and numbness in fingers 3,4, & 5. Neurosurgeon reports I may need another surgery as she is uncertain what the area of darkening shown on my MRI is, swelling, tissue, arthritis etc. My healthcare professional recommended I be seen by Mayo Clinic. I received an email that they are unwilling to take on my case (internal medicine) and this appears to be "common" as I read other threads. Why are they unwilling to review my images, or schedule an appointment? I live nearby and have worked within the Mayo System. Any information will be greatly appreciated!

Why would Internal Medicine be involved? As a retired RN, I am thinking you may want a second neurosurgery consult and opinion. Especially since your neurosurgeon is unsure about how to interpret most current imaging (presume it was postop imaging). I think you need to try again, maybe even ask your current neurosurgeon for a referral letter! Be polite but firmly pushy! Good luck!

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Thank you for your reply. They referred my request to internal medicine b/c of also having an arthritis diagnosis. Shortly after surgery my osteoarthritis dx became concurrent with psoriatic arthritis (mother has psoriasis, r/o psoriatic arthritis) and the rheumatologist prescribed methotrexate for me as I have general fatigue, sore hands and stiffness in my joints. My MH provider told me she saw I had been DX with psoriatic arthritis (which I don't think I have) and stage 3 kidney disease, which was not disclosed to me by the rheumatologist, only that I had "elevated results" –abnormal creatine levels, and I was to continue with the medication and come back for labs in a month. I questioned the DX's, so the Mayo intake worker said I should be referred to internal medicine. I just want to figure out my hand numbness and pain, I am too young to go on disability, I can't write or keyboard for an extended time, and I'm a therapist by trade so it's a must. The ongoing pain just makes me sad, anxious, and depressed. Thank you for your suggestion, although I question how successful a letter will be, it seems physicians are wary of conceptualizing patients of others.

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Don’t give up! I think you definitely need another neurosurgery consult if your own NS is unsure of what is going on. OTOH, if you are physically close to Mayo, as I believe you indicated, then perhaps go see their IM consult. You definitely have comorbidities to be addressed but your other complaints of numbness and pain give one pause! Are those the same fingers as before? As I had mentioned earlier to another writer who had postop issues, I have cared for a number of patients who have ended up with postop symptoms of pain, numbness, tingling, etc. and it turns out they needed a second surgery, based on new imaging – bone fragments, new disc problems, etc. Discouraging yes, but at least a definitive reason for their symptoms and a definite fix!

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Hello @christ and welcome to Mayo Clinic Connect. I understand you are having post-op complications and your provider has recommended you be seen at Mayo Clinic. It seems as though @wisco50 has some sage advice.

If you'd like to try again for an appointment and focus specifically on the reason for the initial referral recommendation, you can use the link below:
http://mayocl.in/1mtmR63
Will you share if you try again?

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Yes, I would be interested in the outcome, how it’s handled, what you find out, etc.

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