The MRI Is for Stroke Patients

I spent days debating writing this, as I know my story is only one of many. However, that's the problem, it's one of millions when it should be the exception. Because of that, I've decided to add my voice to the millions across the country speaking out about the absurdities and abuses of the American healthcare system.

Saturday, I was taken by ambulance to Jefferson Hospital on Frankford in Philadelphia, part of Jefferson Health. Not a decision that I made lightly, but I was out of options. Suffering from severe back pain, leg tingling, and numbness, I was an 8 on the pain scale and barely able to move. For reference, I've already had two lower lumbar surgeries to address a herniation and degenerative spondylolisthesis, so I am not new to this. I know my body and I know this condition, and I knew that something was seriously wrong.

Once at the ER, I was in my room and with staff almost immediately, something that came as a pleasant surprise. I received a chest scan, a CT scan, and a cocktail of non-narcotic pain reliever, muscle relaxer, and stomach medication. Now, before any medical professionals want to argue with me about the merits of a CT scan, I'm now a pro at this and know that an MRI is a must to see the soft tissue and nerve damage that I've suffered in the past. A CT scan missed both of the herniations that led to my previous surgeries. The first time, my quality of life was so poor that I was bedbound and in desperate need of a wheelchair.

When the results came back, the Emergency Room doctor, Dr. Witkin, told me everything looked good. No signs of kidney stones and no slipped discs. Great! Now what about the issues I've suffered with in the past? The herniations and the nerve compression? Wouldn't I need an MRI?

While I was expecting to hear no, I was startled to hear they only use the MRI for stroke patients.

I'm sure that my jaw was in my lap. Only for stroke patients? This cannot be serious, but it was. That was the policy, as I was told, and apparently it is non-negotiable.

I knew the dance was coming, but I had hoped it wouldn't. I explained how I was just laid off and that I only had until the end of the month with my benefits. By the time it took me to see a specialist, get another CT from them, do weeks of physical therapy, go back and finally get an MRI - well, what if I need surgery? At this point, I was looking at one to three months of what I call medical dillydallying.

I pushed back for the MRI, but according to the doctor, I was ambulatory. Sure I was. If you call being in tears, hunched over, using hand-over-hand on the rails to get myself to the restroom ambulatory, then yes, I absolutely was. I asked for a second opinion and was told she was the only opinion I needed. However, she had a compromise. I would be admitted to the Physical Therapy floor and start treatment there. I can't say that I understood, but I thought it was better than nothing.

Several hours after arriving, I was on the PT floor. The staff was lovely, my first nurse gave me confidence that I'd receive the help I needed. When I explained the Toradol hadn't helped much and I was hoping for something stronger, but still non-narcotic, she asked what had worked after previous surgeries. I replied that it had been Fioricet, and there was no issue. Again, I felt a bit hopeful.

Then the next day happened.

The first half of the morning came and went without incident. I was still struggling with leg control, but the pain had died down while I was in bed. Trying to get to the restroom was a different story. Around mid-morning, the attending physician, Dr. Koka, and her PA, Jordan, came in. They never evaluated me outside of pushing on Jordan's hands with my feet. When she spoke, she went entirely off the ER notes and asked why I didn't want Dilaudid. When I stated an allergy issue and that it makes me extremely paranoid and harmful to myself, she scoffed. She read aloud some other medications, all narcotics, and I reminded her that I do not take them. She seemed disinterested and they both left.

An hour or so later, a walker was delivered to my room and I asked if it was for PT. That's when I was rudely told I was about to be discharged. When I asked about physical therapy, I was informed no one would be in on the weekend and I could arrange something outpatient. I had been admitted for observation. Observation of what, exactly, was never explained.

I pressed the call button. To my surprise, the doctor answered, but she was clearly still frustrated with me from earlier. I politely asked why I was being discharged if physical therapy was part of the plan and I had yet to receive it. She raised her voice and told me she had done me a favor by keeping me overnight. I asked her not to yell, to which I was told that she wasn't. So I asked her to mind her tone. Her words: "You don't tell me to watch my tone, I speak to you how I want and my tone is no concern to you," and she promptly hung up on me.

My nurse walked in at the end of the call and scolded me for not knowing that the doctor was dismissing me. I have to be honest with you, this is where I broke. I gave the same as I received, and I verbally bit back. I didn't make it personal, but it was clear I was irate about being held for observation and not for treatment, which was a waste of everyone's time and my money.

A bit later my room was filled with two patient advocates who seemed to sympathize with my plight. Eventually they convinced the PA to come back in to hear me out about being evaluated. I wish I was joking when I say he had me follow his finger and touch my nose. After that, he looked me in the eyes and said "no sign of stroke." I felt like they were playing in my face and I was powerless.

I was discharged with ten pills of codeine, which I didn't want and will not take, a muscle relaxer, Tylenol, and Narcan.

This may not seem like a big deal to many, but I want to spend just a moment on this. I had explicitly stated since the ER that I did not want narcotics. My mother was an addict and my childhood was abusive because of it, something I had told Jordan and the patient advocates. I was sent home with codeine anyway and the added humiliation of Narcan. Again, this may not seem like an issue, but Narcan on your records can create havoc in the future. Anywhere from insurance policies to chart discrimination, Narcan follows you.

But they saved the best for last. My sister came to my room with a bag of clothes and hygiene products in tow, so imagine her shock to learn I was going home. But that wasn't it. It was when my nurse made a point of asking her if she was okay with me taking prescriptions home. She was in shock and I was enraged. I am 48 and I have not had to have a guardian approve medication for me in 30 years, and it would not start that day. As I said, I was giving back what I was receiving.

I left still not knowing what is actually wrong with my back, and I still don't, almost a week later. The specialist they referred me to is a neurologist who specializes in strokes. When I called to schedule, the receptionist was baffled about why I'd been sent to him instead of a spine neurologist. I'm still waiting for his call. I'm still waiting for the physical therapy team to call back. I'm also in a waiting game to see what happens first: someone calls me back, or my insurance runs out. I think I know the answer.

So where does this story leave me? Only with what I already knew to be true.

I will not "not all doctors/nurses" this topic. The healthcare industry is broken everywhere, but especially in hospitals and doctors' offices. Patients are given a mere moment of a physician's time and if you're not bleeding out or actively having a stroke, oh well. However, all patients deserve to be treated with dignity. I happen to know my medical history like the back of my hand, but that shouldn't be necessary, nor does it help. A patient being in pain and asking questions is not a problem to be managed, which is how I was being treated. We are there to get answers and hopefully fix what ails us, and that is the point.

And we cannot keep pretending that tying healthcare to employment is anything other than inhumane. Patients should not have to worry about timelines due to benefits expiring.

Insurance is a rigged game, we all know this. The only winners are C-suite executives and their shareholders. Healthcare for profit means that the margin always matters more than patients, and people who cannot afford to pay out-of-pocket for care are discarded.

Until my story becomes a rare exception rather than one of thousands told every day, I don't want to hear another word about healthcare profit margins.

Fix the problem.