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Major Surgery or Minor Procedure?

The Amazing Difference

Mike and His Sore Calf

The pain in Mike’s right calf started at about a 3 of 10 on the pain scale. For someone in his mid-70s, such minor annoyances were common, and he mostly ignored it for several weeks; but then the pain then increased to what he described as a 6 on the 10-point scale, though beyond the pain, everything else remained relatively unchanged and the pain never spread beyond one specific place in the calf. As the pain increased, Mike described it as feeling like someone had stuck a very pointed knife into his calf muscle.

Mike was a well-versed layman when it came to medical issues and he researched the problem on the internet, looking for clues as to the likely cause of the pain and what might help. Living in a thriving Florida city, Mike had many choices of physician specialists, and he researched orthopedists, neurologists, and physiatrists in his city.

From his research, Mike decided to see a well-regarded physiatrist who put him through a series of tests concentrating on nerve conduction. The tests did not isolate a specific cause of his pain, but they did show an obvious vein blockage over the area of the calf where Mike was experiencing the pain. The physiatrist stated that he had little doubt this was causing the pain, so he referred Mike to a vascular surgeon who agreed with the diagnosis and stripped the appropriate vein from Mike’s leg.

But the pain continued to get worse.

The physiatrist then referred Mike to a pain management specialist, essentially deciding to treat his symptoms and not the cause. The pain specialist prescribed a nerve-blocking medication that he knew would stop the pain, hoping that time would take care of the rest. Mike did not tolerate the medication and decided that pain management wasn’t the appropriate long-term solution.

He then made an appointment with his family physician. Just before his visit, Mike suddenly developed a “foot drop” – which is where the forefoot is so weak that it literally drops. This weakness is caused by irritation or damage to a branch of the sciatic nerve that controls the muscles involved in lifting the foot.

His family physician agreed with the idea that the sciatic nerve was the culprit. He was sent to an orthopedist and underwent an MRI of his spine. This revealed two issues. The first involved a small bone spur that was pinching the L5 nerve and the other was several bulging and degenerated discs at the L4, L5, and S1 levels.

The orthopedist immediately suggested a spinal fusion to replace the bad discs and was confident this would fix his calf pain. He explained that the surgery involved would be complex, require about 6 months of relative inactivity and physical therapy, and would cost anywhere from $75,000 to $125,000.

Though he was tempted to immediately follow the doctor’s recommendation, Mike remembered to ask a question he was taught in the Amaze class. “Doctor, what is the alternative?” The doctor said it was possible that simply removing the bone spur would help Mike’s calf pain, but he still insisted that the bigger procedure would be more effective. Mike then asked, “If I was your dad, would you recommend starting with the minor procedure of removing the bone spur or the bigger fusion surgery?” The doctor paused and then replied that he was not sure. Mike then said that, with all due respect, he would opt for the removal of the bone spur and if that didn’t solve the problem, he would consider the fusion.

Mike had the bone spur removal procedure performed about two weeks later. It was out-patient surgery with a one-inch incision. He went home two hours later, rested for a day, and then played golf the following day. The total cost came in around $1,500, fully paid for by insurance.

The pain resolved and has not returned. Mike thankful for the simple things he learned in his class with Amaze, which was simply the confidence and knowledge to ask the right questions at the right time.

That’s the promise of Amaze: Better care, lower costs, without limits on choice.

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