By Melissa Wardlaw.
Many years ago now, like millions of people around the world, I was dealing with severe chronic lower back and neck pain (and still am). After trying to deal with it on my own for many years using chiropractors and natural methods, I finally went to a spine specialist. He in turn referred me to a pain management specialist for epidural steroid injections. So on the day of the procedure(s), I met the doctor for the first time in the procedure room. He asked me if I wanted both epidurals (meaning the cervical and lumbar) at the same time. Not knowing any different, of course I said I wanted them at the same time! I later found out this was against standard protocol. Long story short, during the cervical epidural, something went wrong and the epidural needle transected all the way through my spinal cord causing a SCI at C5/6 levels (as evidenced by MRI films). Thankfully I wasn’t paralyzed even though many doctors after the fact said I should have been. Ultimately, this was considered a major complication for which I signed a consent form.
Even though a subsequent diagnosis of CRPS type 2, among other severe chronic illness/pain and other debilitating issues took me out of the game (and life for many years), disabling me then and still now, the doctor was able to walk free and is still practicing medicine (and performing epidurals).
If only I could go back and do things differently, I might not have suffered so greatly. I should have thoroughly researched what an epidural steroid injection was and what to expect prior to, during and after the procedure(s). In addition, I should have asked the doctor a whole host of questions.
So to prevent others from encountering a similar fate, below I have included some questions I should have asked the doctor before my epidurals (or any invasive medical procedure or surgery):
1) How many times have you performed this procedure and when was the last time?
Make sure the procedure is something the doctor is experienced at doing and does on a regular basis. If he can’t answer when the last time he performed the procedure was, this probably means it’s not too common for him and you might consider going to a different doctor.
2) Can you please walk me through what will happen before, during and after the procedure?
The doctor should be able to tell you in detail what the process entails from beginning to end – with confidence. He should tell you if you will be put under anesthesia (light sedation or general), how long the procedure will last, what exactly will be done during the procedure, how long your recovery will last and what you should expect in your recovery, including medications you will be prescribed (and if you need to fill them prior to the procedure). If he can’t answer ALL of these questions, and any follow up questions you have, something is wrong and I would run!
3) Have you ever had any complications?
Most doctors will have had at least a few complications in their years of practicing medicine – the key is, what happened during these complications. For example – Were they major or minor? How did he react during the complication(s) and what did he do to counteract the complication(s)? If a doctor tells you that he hasn’t had any complications, it might be a good idea to get a second opinion because he’s either extremely lucky or lying!
4) What are my chances for success?
The doctor should be able to give you some sort of guide or statistics for what to expect as far as what the procedure will do for you and your condition. You should be able to justify having an invasive procedure done in the first place by asking your doctor to explain why the procedure is necessary or even worth the risk.
As an example, I had a lumbar fusion (invasive surgery) many years ago; they used coral material and I was under the assumption it would cure the back pain I had – otherwise why have the surgery? Well, after the surgery, my pain was not any better and possibly a bit worse, shifting a little bit more severely to the right side and making my sciatica worse. I asked the doctor why the pain wasn’t gone. He told me that it only helps the pain in approximately 30% of cases! But it does help the mechanical issue he said. Only 30% chance of even helping the pain??!! On top of this, he told me it would take a year to fully recover!
Needless to say, had I done my research and thoroughly questioned the surgeon beforehand, I would have found out this information which might have changed my mind about getting the surgery altogether!
5) What are the percentages of success you’ve had in other patients – referrals?
It’s important to find out about success stories the doctor has had and even ask for referrals from other patients – yes, referrals! If the doctor is confident in his abilities, he won’t be scared to give you the names of a few patients who have had the exact same procedure you are thinking of having. This way you can not only find out how other patients fared, but also exactly how their experiences were with the same doctor. This information is invaluable, will add to your preparation and ease your anxiety.
6) Have you ever been sued for malpractice?
This might sound like a controversial question, but I do wish I would have asked the doctor who caused my spinal cord injury this question. Many doctors have been sued for malpractice, so just having been sued doesn’t necessarily mean much; what you are trying to determine is if the doctor has any malpractice suits related to the specific procedure(s) you are considering and if so, what were the issues surrounding it.
In addition, if he has been sued for malpractice, this will allow you to do further research and determine if the facts match up to the information he’s giving you. It is also very easy for doctors to settle or win malpractice suits because they have many skilled attorneys defending them. In my situation, had I done my research into the doctor’s background, I would have found pending malpractice lawsuits and complaints, which is a clear sign to, at the very minimum, investigate further or find a new doctor!
7) Can you please elaborate on (X, Y, Z) internet review?
These days, most doctors have reviews on the internet which makes it a little easier to research them and feel more confident in your decision to use (or not use) them. However, as we all know, just because a doctor has a negative (or positive) review, it doesn’t necessarily reflect the accuracy of the situation that occurred. The patient who reviewed the doctor may have been exaggerating or lying altogether to get revenge. So if the doctor has negative reviews, it’s a good idea to ask him his side of the situation to 1) see IF he answers it and 2) gauge his answer and see if he takes accountability or even feels bad for the patient’s negative experience. The point is, his answer can tell you a lot about what type of doctor and person he is, and therefore if you want him performing an invasive procedure on you.
8) Are there any alternatives for me besides this procedure?
Before going through any invasive procedure, it is imperative that you are 100% sure the benefits or potential rewards outweigh the risks or potential side effects. It is usually prudent to exhaust all other non-invasive options prior to taking the invasive route if you can. So make sure you allow your doctor to go through all other treatment options to help determine if the procedure is right for you.
In summary, every procedure, no matter how small, carries the potential for risk. Minor complications during procedures are relatively normal and should be anticipated – particularly if the procedure is done by an experienced physician who performs the procedure on a regular basis. Having complications during a procedure or surgery is not uncommon because frankly things go wrong when there are so many variables in play – how the doctor handles the complications however, is the important part. You can and should reduce the number of variables by educating yourself in a variety of ways.
There is an excellent TED talk by Dr. Brian Goldman about making mistakes in medicine that should be required viewing for ALL doctors and patients – you can view it here: https://youtu.be/iUbfRzxNy20
I encourage you to use this guide and make sure to research and question your doctor BEFORE your next invasive procedure. You owe it to yourself and your life!
Melissa Wardlaw was diagnosed with CRPS/RSD as a result of a spinal cord injury (non-paralyzing) suffered during a routine medical procedure. She also suffers from fibromyalgia, lumbar and cervical degenerative disc disease, migraines and additional chronic medical issues. Formerly a Business Executive/Consultant with an MBA in Entrepreneurship, she is also a Certified Career Coach and Certified Professional Resume Writer, and now spends her time career coaching and offering peer counseling/advocacy (pro bono) to those dealing with similar medical struggles. As a fierce advocate, she also runs both in-person and online Support/Empowerment Groups for CRPS/RSD and Chronic Illnesses/Pain in the Metro Atlanta area. A “fur mom” to two cats, Melissa is an avid volunteer and supports multiple organizations committed to rescuing animals and helping those with chronic illnesses/pain. She can be reached at firstname.lastname@example.org.