It was been 19 months since I went into the splits and tore my hamstring. Yesterday, I went to a new orthopedic.
I began treatment with my first orthopedic about a year ago, last January. He gave me a steroid shot and sent me to physical therapy. After dry needling, massage, and strength training did nothing or potentially made it worse, he finally sent me for an MRI. He told me I had a minor tear with no details. He gave me a PRP injection then told me we were at the end of my treatment.
I had this initial PRP back in May. It cut my pain in half, so a vast improvement, but then it just plateaued. It was better but not recovered, improved but not healed. I was fine to deal with it. Besides, my doctor had given up on me and told me there was nothing more he could/would do for me. However, when the pain seemed to increase again and it was driving me from my bed at night, I decided it was time for an evaluation. If nothing else, to verify I wasn’t making it worse.
I understand that hamstring injuries are notoriously slow to heal. Yet the lack of any progress and appearance of regression concerned me. Also, my doctor’s treatment (or lack thereof) left me with so many questions. Was I doing something that could be making it worse? At what point should I be worried? I had to know, so I got the referral for a new doctor.
After just my one visit yesterday, I can say that my experience with this doctor is a night and day contrast to my previous orthopedic. I did not know the extent of my dissatisfaction with the first until receiving the superior treatment from the second. Allow me to compare the two experiences.
My first doctor and his nurse were very rushed and impersonal. They asked questions but did not seem to actually listen to the answers. I spent extended periods in the lobby and patient room, waiting. I told them in my first visit that I was there to resolve my pain. I then repeated this every visit, yet they never wanted to treat my pain. They only wanted to get me back to activity.
Conversely, this new doctor and his nurse were extremely friendly and attentive. At each stage, I waited for normal and reasonable amounts of time, yet they continually checked in on me to communicate a status update. They were so attentive that it was startling. They also both connected with me. They looked into my eyes when they spoke to me. They responded to the previous thing I said. They waited for me to speak as if they wanted my answers.
I felt so much more comfortable at the new office. I felt like I actually mattered instead of being dismissed and ignored.
When my first doctor got my MRI results, he told me I had a minor tear. That was it. Despite any queries, he only said that and also that the technician probably would have never seen something so insignificant had he not pointed it out. He and his nurse seemed to trivialize and minimize my injury at every appointment. Their dismissive demeanor made it feel like they either did not believe I was injured or doubted its severity.
I learned yesterday from my new doctor that this same MRI showed that I had a labural tear tear in the same hip. The outside of that hip also showed inflammation, most likely from the injury I had before the hamstring. He told me my hamstring had a partial tear, approximately 20%. However, he said, the tear was not on either edge, instead it was in the center of the hamstring, making it extra difficult to heal.
All information that would have been useful A YEAR AGO.
My first doctor told me I could have a steroid shot and gave me one. He told me I could have a PRP injection and gave me one. Then he terminated my treatment, deciding he was done and there was nothing else he could do for me (another indication to me that he did not consider me actually injured).
This new doctor explained my six different options and quoted me the out of pocket price for anything not billed to insurance. I could:
- Get a new MRI
- Get one or more PRP injections
- Get stems cells from a donor
- Get stems cells harvested from me without anesthesia
- Get stem cells harvested from me with anesthesia
- Have the reattachment surgery
Not only did he provide me these options with price tags, he then walked through the pros, cons, and his experience with each choice. He told me that surgery would be his last resort because, with my injury, it could potentially sacrifice the 80% healthy hamstring to repair the 20% damaged. He told me he would prefer the biologic options (PRP, stem cells), but PRP has the most data and evidence behind it. If he did stem cells, he would recommend harvesting my own to eliminate risk of cross-contamination or rejection.
Then he encouraged me to ask questions and share what I thought I would like to try first. I opted to start with another PRP injection, which he then provided me at this same appointment. Then he set a follow up appointment to check how the PRP took and determine next steps.
Yet, with all this, the most glaring and important distinction between the two doctors and my experiences with them was the administration of my PRP injections.
At my first PRP injection, the nurse took my blood and spun it down in the room with me. When the doctor came in, he had me bend over the examination table. This aggravated my injury and felt very awkward. The nurse jabbed the ultrasound into my butt while the doctor stabbed the needle into my tendon. Afterward, he informed me this was all he could do for me. When I told him I really needed something for the pain, that the constant pain was affecting the rest of my life and making me short with my children, he reacted as if I had never mentioned pain and was drug seeking. He gave me Tramadol. As if being unconscious would solve my problem.
Yesterday, the nurse took my blood. While she was waiting for it to spin down, she checked in on me and told me how much longer I would be waiting. She set me up laying on the exam table on my stomach with a pillow. When the doctor came in, he covered me (as much as he could) with a paper blanket. He informed me he was going to start the ultrasound and placed it gently against me. He told before he marked for the injection and inserted the needle. He communicated each step before taking it. After, he sat down with me, and we discussed recovery and expectations and follow up appointments. He shook my hand before leaving. Then the nurse came in and set up my appointment before walking me out.
The two experiences of the exact same procedure were so different, so polarized. After the first one, I felt very uncomfortable and unnerved, generally unhappy. Being bent over the table, stabbed, and then dismissed so impersonally made me feel violated somehow. It never sat right with me and doused any hope I had that the injury pain might actually subside.
In contrast, I left yesterday’s appointment feeling optimistic. I felt like the doctor had actually heard me and I once again had options. And even if my circumstances do not change and the injury does not heal, I at least feel like someone gave a shit and tried. It was simple subtleties and seemingly insignificant details that made me feel violated and dismissed versus cared for and treated. I don’t think anything unethical or inappropriate happened at my first shot and I don’t necessarily doubt my original doctor’s medical knowledge, but I do see now how wholly unsatisfied I was with the treatment I received from him.
These experiences reminded me how individual doctors are and how unique a medical experience can be. Getting an injection is not just getting an injection. The circumstances, environment, and care are crucial factors. I am hoping a more favorable experience cultivates more favorable results as well.
For now, I will be on the couch, willing my body to heal itself.