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The Big File All issues not easily categorized in the above forums are here. Comments on general health, diet, "getting comfortable," and more are here.


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  #1  
Old 10-10-2005, 10:09 PM
cervie queen cervie  queen is offline
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I find it absolutely amazing that my insurance would require a psych assessment (ha! I passed) prior to implantation of a spinal cord stimulator, but no sush assessment was required prior to major back surgery. Any answers?
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Old 10-11-2005, 12:07 AM
Justin Justin is offline
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Poor psych assessment correlates with poor outcome (in most situations). I think it was required in this situation because the SCS requires the patient to be willing and educated about the device before implantation. If patient compliance is a foreseeable issue, the benefit of the device is minimal. Not sure if this is on the right path of reasoning...

Justin
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  #3  
Old 10-11-2005, 02:22 AM
sahuaro sahuaro is offline
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Well put, Justin. I think it is fascinating that the insurance (Medicare?) required the psych assessment rather than the physician. See the article posted by Harrison in the Article Library on psychosocial factors and spinal surgery.
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2001 MVA; C5-C6 disk extruded
ongoing physical therapy, exercise and massage
ESI's, oral prednisone, trigger point injections
foraminal and central stenosis C5/C6 and c6/C7
2007 EMG/nerve conduction shows pattern of chronic radiculopathy
January, 2008: Prestige ST Artificial Disk Replacement, C5/6
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  #4  
Old 10-11-2005, 06:02 AM
Alastair Alastair is offline
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It's amazing the way these doctors minds work -- -- -- what a big benefit of having Justin on the board here
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  #5  
Old 10-17-2005, 11:13 PM
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Hi, I am new to the forum but not to the back support board. I'm not a candidate for ADR but am extremely interested in it.


I believe the reason for the psych evaluation is


to see if you are emotionally stable enough to tolerate a foreign object in your body.

Carol
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  #6  
Old 10-23-2005, 06:32 PM
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My findings have been that the psych eval is to see what the patients expectations are vs. the reality of what if...what if it does not do all of the things in which the patient may think the operation or major procedure promises to do, in their perception...What if there is still pain? What will you do with your life, What if this new disc in your back does not allow you to go back to work and do the things in which you thought you would be able to do after the procedure etc...

Anyhow - that is what I think they give them for. If a patient is not grounded as to the 'what ifs' then they have someone unprepared to go into it in the first place.

I am not yet a real candidate for ADR and enjoy being here too, yet I am not the most knowledgeable here...I have just asked a lot of questions as to why on the psych eval too because I needed to know why before taking one.
Thanks
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  #7  
Old 10-23-2005, 06:51 PM
mmglobal mmglobal is offline
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Back when I was looking for a surgeon to do the 2-level fusion I was sure I needed, Doctor 90% required an MMPI before surgery. (Minnesota Multiphasic Personality Inventory)

Results are paraphrased:

Patient may be amplifying pain in order to generate attention.....

or.....

patient may be experiencing severe, chronic pain.


Well, thanks a lot for the definitive results! This is like a rorschach test for the doctor... he can see whatever he wants to see.

Wouldn't it be great if medicine was a science?

Mark
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  #8  
Old 10-23-2005, 07:04 PM
sahuaro sahuaro is offline
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Mark: As a psychologist, I don't like the MMPI but it's a favorite test because (1) it doesn't require much time and effort to administer and (2) it generates numerical scores, so people assume it has validity. What your report indicated is that the MMPI cannot tell if pain is real (duh!) and my hunch is that the psychologist who submitted the report just took the results off a computer program and added no thoughts or judgment of his own. A good pre-surgery psych assessment should address patient coping skills, to put it most simply.
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2001 MVA; C5-C6 disk extruded
ongoing physical therapy, exercise and massage
ESI's, oral prednisone, trigger point injections
foraminal and central stenosis C5/C6 and c6/C7
2007 EMG/nerve conduction shows pattern of chronic radiculopathy
January, 2008: Prestige ST Artificial Disk Replacement, C5/6
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  #9  
Old 10-23-2005, 09:12 PM
Juli Juli is offline
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This is yet another example of the roadblocks put up by insurance companies to find any reason to deny coverage. Just imagine the folks who are not fighers, who are not capable or inclined to do research on their own behalf. I am sure this type of thing works for the insurance companies a majority of the time. While I am angry when I look back at my own experiences, at least I was able to work through them and get the treatment I wanted although a significant portion came from out of my own pocket. (With a lot of help just from this site alone)

I can't believe this continues to occur in our country daily and still health care is not a top 5 issue in politics except possibly among seniors. How can other subjects such as the display of the ten commandments and gay marriage take precedence over something that affects the health and lives of americans every day?

I better stop now or I will have a novella here. But, I completely agree with Mark above. Medecine is part art and part science. I still look back on the varying diagnosises (sp?) that I have had in the past couple of years alone, all from "top doctors" and am thankful I did not stop with the first assessment or even second assessment.
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Feeling great!
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  #10  
Old 10-23-2005, 10:23 PM
sahuaro sahuaro is offline
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Juli: Psychological assessment serves a useful and helpful purpose in helping patients prepare for and rehabilitate from surgery. It is used for all types of surgeries, including but not limited to gastric bypass and plastic surgeries. In fact, the Texas Back Institute has a staff of psychologists who are apparently actively involved in assessment and treatment and have published a book entitled, "The Psychology of Spine Surgery." Unfortunately, some psychologists are less knowledgeable than others in this area--as with any profession.
I don't know why it was the insurance company who insisted on a psych assessment for cervie queen--again, I find that quite interesting and wonder if the other members who underwent psych assessments were referred by their surgeons or by their insurance companies.
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2001 MVA; C5-C6 disk extruded
ongoing physical therapy, exercise and massage
ESI's, oral prednisone, trigger point injections
foraminal and central stenosis C5/C6 and c6/C7
2007 EMG/nerve conduction shows pattern of chronic radiculopathy
January, 2008: Prestige ST Artificial Disk Replacement, C5/6
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