Because it is rare, some who develop 카우 말 증후군 are the victims of 의료 과실. 일화 이야기는 풍부, 문서화 된 것들과 함께, CES는 자아 또는 과실에 의해 악화되는 것이. Given the laws covering malpractice in varying jurisdictions and the variability of each person's CES, no one can be certain if a case exists or how it will turn out. This is my story. It has been reviewed by 2 Ohio attorneys who have experience in Cauda Equina Syndrome malpractice cases. You won't like what it says about our legislatures, legal system, and of course doctor education.
My Cauda Equina Syndrome started with my injury. Within 10 hours of the onset of my CES symptoms, I was in an Emergency Room in Westerville, OH. Upon waking on the morning of Feb 12, 2013, I found that I not only had the severe back and sciatic pain of the night before, but now I was NUMB from the waist down! I could not void my bladder nor defecate. 나는 내 발을 움직이지 수 도 아래로 내 발과 발목의 느낌없이, 나는 균형 없습니다. 다음은 마미 증후군의 모든 고전적인 증상. 다행히 우리는 휠체어를했다 (일부 성인용 기저귀) 그냥 후 10 오전, 나는 휠체어에 응급실에 도착.
우리는이 ER 빠르고 효율적이라고 들었다, 그리고 마미 증후군을 의심 의사의 사무실에 가까이와 ER 우리를 보내 (특정 방향으로 MRI를 수행해야합니다.) 즉시 응급실에 도착, 나는 시험 방에 바퀴가 달린 나는 시험 테이블에 내 휠체어에서 옮겨졌다. 내 바이탈가 찍은 나에게 할당 된 남자 간호사는 초기 평가에서 온. 그는 '5 서 있었다 4", 약 150 파운드, 즐거운. 개별 내 증상에 대해 물어 시작 사람. With my mentioning Cauda Equina Syndrome, he asked if I was incontinent. I said, "No. I can't go!" He then asked me to stand up. I told him I couldn't. I knew I would fall right over, not because my legs wouldn't support me but because I had no balance. And I knew that his small frame would be overwhelmed by my 6 foot tall, 325 pound body. No way he can stop me from falling over if he doesn't prevent it to start with. I told him so, yet he insisted. The results were predictable. On standing up, I immediately began tilting (away from him, naturally) and over I went. The nurse could no longer stop it. The rolling chair in front of a fixed desk was in line with my movement. I was able to grab the back of the chair and as it rolled into the desk, it locked in and I was able to stop my fall. He asked me again if I was incontinent. I responded as I had before. That concluded the initial exam.
A short while later the nurse came back in. He told me that the ER doctor had ordered an MRI for me. The MRI machine was located at the other end of this Ohio Health Medical Campus and did not have an opening for me for almost 4 시간. I had to wait, on that exam table, in pain, until then. The nurse did check on me a couple of times, one time bringing me a couple of replacement diapers as my bladder was so full it was leaking (I still couldn't go!) Thankfully, my wife had some snacks in her purse or I would have been without food for over 10 hours that day - not good for a diabetic! No one ever asked if I was hungry, even though I was there over lunch time. Around 2:15 p.m. the nurse came and took me to the MRI machine. As we wheeled in, I could see that the machine was an older type that was very small. I did not think I would fit. They told me the test would last about 45 minutes and that I needed to lie as still as possible (easy to do when you rate your pain at a 10 and you are not medicated - NOT). I was put into the machine and I did fit, 그러나, as I tried to breathe,
I could not fully expand my chest to take in a breath. I could get no more than 1/2 a breath before the constriction of the machine prevented further expansion of my chest. After several partial breaths, I knew that I could not breathe this way for 45 분. I told them so and I was removed from the machine - it was just a little too small. 나는 응급실로 다시 선회되면서, 간호사는 큰 기계 및에 대해 이야기 개방형 MRI 지역의 기계. 그는 말했다, "우리는 그 중 하나에 당신을 얻을 수 있습니다. 우리는 우리가 그것에 대해 무엇을 할 수 있는지 볼 수 있습니다." 나는 기다릴 시험 테이블에 반환. 반은 시간이 아무도 나 한테 확인하지와 함께 전달. 그런 다음 ER 의사가 도착. 그는 누구 얘기하고 그 사람이 내주의를 감독했던 것을. 내가 자제 할 수 있다면 그 후 두 번 나에게 물었다. 다시 나는으로 대응, "자제 할 수 없음, I can't go!" 그런 다음 그는 말했다, "당신은 마미 증후군이없는. 우리는 응급실이며, 귀하의 경우는 응급 아니기 때문에, 우리는 외래 환자의 MRI 시설에 당신을 참조 할 수 없습니다. 나는 당신에게 우리 그룹의 등 전문가에 펄 코셋에 대한 처방전 및 추천을 줄거야, 첫 번째 사용 가능한 약속. He can order an MRI for you." With that he was gone.
Shortly, a person came in and told my wife and I that 2 more people would be coming in, one with the discharge papers and another to wheel me out of the facility. 약 3:15, the woman with the prescription and discharge papers came in. The discharge papers said I should come back to the ER if any of my symptoms got worse OR if I developed any of these symptoms:
"Increased pain, abdominal pain, fever, difficulty controlling bowel/bladder, or any further concerns."
That was on one page of the instructions.
Another page stated this:
- Loss of bowel or bladder control (you soil of wet yourself).
- Weakness of inability to walk or user your leg(s) or arm(s).
- Pain not relieved by pain medication.
- Fever (temperature over 100.5 F) or shaking chills.
- Severe pain that settles over one particular vertebrae (bone) in your back."
I laughed when I read these! Well as much as one can laugh while in the worst pain I've ever felt. 나는 already had most of these return or get immediate attention symptoms!! The woman said that these were just generic discharge instructions for herniated discs and not specific to me.
Most medical literature states that decompressive surgery must be done within 24-48 hours or the outcome is far worse. Once those 48 hours are gone, you're pretty well going to wind up disabled for the rest of your life. So says the literature. I can tell you right now that that is not always the case as I'm living proof, but that is another story.
Other medical literature says that the surgery must be done within 6-12 hours to effect the outcome. Still other studies say that time to surgery doesn't affect the outcome. Why such divergence? Cauda Equina Syndrome is rare. No one knows exactly how rare, but my research of available estimates would indicate no more than a few hundred new cases a year in the U.S.
It ultimately took 2 weeks for my surgery to be performed. The surgery at Riverside Methodist Hospital in Columbus, OH went well, I went through Acute Rehab there for a week after the surgery. I then went through 15 sessions of Physical Therapy at NovaCare in Westerville, OH. My outcome is that I have some normal feeling again in my waist area somewhat in my thighs and in my shins. I have painful tingling in other parts of my thighs and in my feet. My calves are mostly numb unless pressed upon - then I can tell the leg muscles are cramped up, but the good part is that I can't feel the cramps. I do stretches several times a day for calves and hamstrings. I use vision for balance and the leg weakness has diminished, i.e. strength has returned, to the point where I can walk about 500 feet with a cane and about 125 feet unassisted. Bowel and bladder functioning is that they function, I just can't control them or tell when I have to go - I get surprises. I try to go on a regular schedule to avoid surprises and I can tell most of the time when my bladder is getting close to the leaking point. I get a minute or two of warning on bowel movements most of the time, but I don't generally feel them.
In other words, my delayed surgery should have left me disabled, in bed, cathing myself, and on pain killers. I work full time, am ambulatory over short distances don't need cathing, and am on mild, non-narcotic pain relievers. In short, my recovery has been great. One of the best. 그러나, I still have a life of everyday being a physical challenge and struggle. That won't change, but that's okay (subject of another story.) I did a lot of wondering if I would have gotten back to normal, or almost normal, had I had surgery quickly, 이내 48 시간. Feeling that the care I received from the ER doctor was negligent, I took everything to a Columbus, OH attorney. He called on another attorney in Cleveland, OH for a second opinion.
They both agreed that malpractice was committed, that the ER doctor "dropped the ball" as one of the attorneys put it. 그러나, due to the standards for malpractice claims in Ohio, both attorneys felt that proving that the doctor's negligence greatly affected my outcome (my really much better than predicted by the facts outcome) would be an insurmountable challenge in court. Since that is the portion that really drives the dollar amount of any settlement, and thus the attorney's fees, my remarkable, blessed recovery makes pursuing the malpractice and negligence of the ER doctor not feasible. If I had not pushed to recover, I could have gotten a nice settlement... I'll take my recovery anytime!
So the summary is that the laws in Ohio say that what I've been through, and will go through the rest of my life, amounts to nothing. Our legal system is such that only lucrative cases are pursued. And our medical system does not educate doctors, nurses, and first responders adequately nor does it keep them updated. Had the ER doctor realized that bladder retention and not only incontinence is an indicator, we would have been golden. The info regarding retention is widely available on the internet and in medical journals.
To discount the correct diagnosis on the basis of 1 symptom is not what I want in a doctor. I feel that justice has lost in this one. 그러나, I am at peace with this as I relate in this post - My Blog Title Changed but Still About Cauda Equina Syndrome and Me.