My Experiences With 10 Neurologists
The foregoing is a lengthy description of many experiences with neurologists, good and bad in my 13 years of post-stroke survival, Unfortunately, it doesn't include recovery. But it does stress the importance of a second opinion, especially in situations of a surgical nature. It also reveals the limitations of neurology, and although advances have been made in brain study, there is still much which is a mystery. Perhaps in the not too distant future, stem therapy advances may bring to life areas of the brain with awakened neurons and tissue. Lastly, neurologists are no different than other people with all their shortcomings and accomplishments, they do on occasion err!
Neurologist 1:
My first encounter with a neurologist occurred when I was hospitalized with my stroke 13 years ago.. He was a cheery man in his fifties who headed a group of neurologists in private practice. He informed me I had a brain stem stroke, but not to worry as the Willis Circle provides sufficient blood flow from other arterial sources. Four days later, he informed me that physical therapy was to start the following day, but was canceled due to it being the start of a holiday weekend, so he will release me as I could do exercises at home. At the time I couldn't even situp in bed, let alone stand. But I foolishly agreed, thinking his comment meant that a quick recovery was imminent. Fortunately, my son took it upon himself and phoned the doctor, stating that I was in no condition to be sent home and my wife's health condition disallows her from being a care giver. The doctor had second thoughts and apologized to me that he was errant in his decision and I was fortunate to have such a wise and thoughtful son. I was transferred to another hospital to start physical training.
Neurologist 2:
One of two neurologists visited me daily, asking me to touch my nose and their raised finger followed with a quick listen to my heart and disappeared with no comment, having earned $60.00 for 2 minutes time, followed by an internist who also listened to my heart( though a bit more thoroughly) with a quick but silent exit. After two weeks, I was transferred to a nursing home of my own choice with a head trauma wing,
Neurologist 3:
The wing accommodated 21 patients of various ages,suffering from a variety of head injuries, housed in single rooms. I had a good rapport with the neurologist and continued to see him after my release 2 months later. After several visits, and negative reactions to prescribed medications, he told me there was nothing more he could do to improve my condition.
Neurologists 4&5:
The first doctor stated my brain stem stroke was congenital as shown by the MRI showing the right vertebral artery being much narrower than the norm. His associate, seen for a second opinion, disagreed with the finding. Medicines were ruled out since they worsened my vertigo, and neither could make recommendations for improvement.
Neurologist 6:
Chief physician with a large neurological center, stated in a tactless manner, upon the completion of my examination, that nothing can be done ( this despite that he also headed the vestibular training unit) to improve my condition, which will continue to deteriorate.
Neurologist 7:
One of the most prominent neurologists in the County, prescribed a host of tests in the above facility in which he is partner. He suggested that the right ear vestibular nerve be “killed” with a series of gentamycin injections as the nerve is sending garbled messages to the brain causing vertigo and ataxia. He stated the only risk is hearing loss in that ear, but vestibular training will compensate with the left part of my brain compensating. I foolishly did not seek a second opinion and had the procedure done by a neuro-otologist he recommended. Immediately with the first injection my balance worsened and I had to revert to using a walker in place of my cane, and was left unable to drive and surrendered my license. I visited another neuro-otologist to determine if I should proceed with the series of injections, and he angrily stated that the procedure should never have been done as you can't correct a brain injury by treating a peripheral area. He further stated that its too bad that I didn't seek a second opinion before the procedure and that it is important not to continue further injections while I still have some balance on my right side.
Neurologist 8:
Although he was furnished with radiologists' reports and MRI discs as well as my statement that I had a brain stem stroke caused by an occlusion of the right vestibular artery, he recommended a current MRI and MRA. Upon receiving the results, he phoned my home and spoke to my wife in my absence.
He stated that it is important that I see a brain surgeon at once since there is a clogged blood vessel in my brain. My wife stated that I will call him back within the hour and he replied that he won't be available for the next two days. On my return, my wife conveyed his message, which aroused my anger. He had no right to to give such alarming news to my wife. I questioned his urgency and suspected he was relaying old news, but then again, perhaps there was another blockage. I called the radiologist and told him of my concern in the doctor's absence. He was very cooperative and reassured that there has been no change from earlier MRIs and doesn't see any indication that warrants the attention of a neurosurgeon.
I didn't chastise the doctor on my next visit as I didn't want to jeopardize a building relationship as I was running out of prospective neurologists in my quest for help. After another two visits to his office, he recommended a neurosurgeon whom he felt should review my MRA. I silently questioned the need as the report I read showed good blood flow in the brain. But I humored him, thinking there may be something I am overlooking. The surgeon briefly reviewed the MRA and stated that there is good blood flow and couldn't understand why I was urged to see him. Needless to say, I stopped seeing him after he admitted that he is baffled by my case and recommended that I see an internationally praised neurologist at Columbia University Presbyterian Hospital who limits his practice to difficult cases recommended by only a few neurologists.
Neurologist 9:
After googling the doctor's background, I set an appointment and was greeted by the physician who appeared to be in his middle to late seventies. He was cordial and old school polite and very thorough in his examination, asking me to sit beside him as he explained the study of my MRIs. At the conclusion he stated that he was very sorry, but there was nothing he can do to help me, adding that I unfortunately fall into a small group that fails to experience recovery. He further stated that vestibular training would be of no avail for my condition. I thanked him and said I guess there is no sense in visits to a neurologist. He stated to the contrary, it is important that I routinely continue to do so.
Neurologist 10:
While disappointed with my last neurological appointment, it brought to closure my quixotic adventure of fighting windmills. My intent was to find a neurologist I can be trustful and at ease with. Through my google search I found a young neurologist who appears to be very dedicated to his field with the ability to be empathic and a good listener. While he is updated in modern medicine, he takes pride in having been trained by older physicians with patient centered ethics and seems especially interested in my case as his dad is also a brain stem stroke victim. He states I am his most difficult case, but while he offers no optimistic expectations, he doesn't shrug in despair. “I think I can now accept the serenity to accept the things I cannot change, and the courage, the things I can”
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