Atcpup

Whoa Mike, I think she(?) likes you..Emphasis on ANALogous

Mike5215

Wait a minute. A prudish lawyer who drives a Porsche and hates dick-jokes. Holy crap! I'm being flamed by Elle Wood!

mnje350

It really is pretty easy to avoid a thread where you don't care for the content. You have expessed your point. Move on. It's only gonna uglier, or, depending on your viewpoint, funnier from here.

NaslundStarmine

"Admittedly, I think I may have made a comment or two too quickly instead of paying more attention to what I was responding too."

Yep.

"I think one was about a CPO post, but you're obviously missing the point."

Nope.

"If you're suggesting my comments have no merit because of my total number of posts, that's ridiculous."

Made no mention whatsoever of the # of posts you have made.

Of course people vent, but this is a car forum and a place to vent about cars and other associated issues."

Or in Mike's case, his half numb pecker and half numb sphincter.

"This is not a medical forum and I found some of the OP's comments a little crass.'

I too found them a bit odd upon first reading but didn't jump to any conclusions.

"That's my opinion and I don't particularly care whether you agree."

Sure you do, if you didn't you'd have ignored me.

"Since you know nothing about me, your insults are meaningless, but the fact that you feel compelled to resort to insults says something about you and whatever insecurity or ego issues you may have."

So you really did go to law school somewhere in the Caribbean Netherlands?!? That was a shot in the dark but hey glad to know I got it right!

Mike5215

So we have a meeting with a Med Mal attorney on Wednesday. I've never heard of the guy but I gave the case to one of my customers who does PI stuff for him in turn to farm it out to a heavy hitter without local ties. That way my friend gets a third of the third of any settlement for himself. He does a lot of little favors for me and I like helping him out when I can. If the guy likes the case (and he'll only take decent cases) he will front the $5k independent medical eval from a Neuro not affiliated with the local docs. If the opinion is negligence, or even potential negligence, we'll put together a high value time limit settlement demand for the med mal carrier. Cases tend to either settle pre suit or in mediation. Very little actually gets litigated.

There's always a chance our doc won't find negligence, in which case it's over but at least I'll know.

Awrryan

I really do wish you the best of luck and a speedy recovery. If there was malpractice, you deserve to recover. I can't imagine what you're going through. My only intention was to try to convey that I found some of your comments inappropriate and crass. Just my opinion. Not judging. Not trying to insult you.

mrbobby

It sounds like everyone understands the other. I, personally, get a laugh out of Mike's comments. Having said that, I do sometimes find him a little "over the edge". This is my opinion and worth exactly what I charged. Let's all agree to disagree and move on.

Kind of a bad pun Mike, but "keep it up".

Mike5215

It wasn't especially insulting, just sort of an awkward interjection. Usually if I'm reading something I find distasteful (I'm not sure what that might be but I'm sure it's out there somewhere) my reaction is to stop reading it. I rarely feel the urge to admonish the author. I say "rarely" because some stuff does actually **** me off. When it does, I'm the guy making the awkward interjection (and taking the heat).

No harm done. If this surgical experience has done anything, it's reinforced my determination to not sweat the small stuff.

mnje350

Well said.

KNBS550

Mike, if no one has told you, you can be a little outspoken on this forum. That said, I think you are taking your situation pretty well considering your man tool doesn't work like it should. I'm at the age where I no longer get a hard on when a smoking hot woman passes by and have come to realize that my years are numbered. I think you have the right perspective about not sweating the small stuff. To me every day we're above ground, can be around family and friends; and fortunate enough to drive an S-Class is a good day.

mrbobby

Amen gentlemen. While I, personally, am not at the end of the road, I can certainly see it from here. I try to find the strength to change the things I can and accept/move on from the things I can't. I've got too little time left to let stupid things **** me off, although, I must admit, sometimes, I get sucked in.

Mike5215

Dude, I no longer get a hard-on when there's a hot naked woman underneath me patiently waiting for me to get a hard-on. That's a real problem for a guy in his 50's. Especially with a wife in her 40's.

What the surgery did was create a clear demarcation between my youth and old age. Where I think guys normally transition slowly into that state where the plumbing stops working, I got there overnight. It's learning to accept the abruptness (and possible permanency) of the situation that's the challenge, and then figuring out how to get "back in the saddle". I'm encouraged actually that there's a mechanical (rather than mental) explanation for the ED, and that there is a fix, although I could use some ideas about incorporating a penile injection into foreplay.

And yes, the S Class is one of many things I'm grateful for.

Mike5215

So this thread is going to evolve from me being shell shocked from my new apparent reality to me trying to find some equilibrium in the whole mess and that regrettably might involve litigation. If you find that sort of thing distasteful I don't hold it against you for abandoning the thread.

I had an informal meeting with a respected med-mal attorney. Didn't sign him, but gave him a med auth to order records. I also advised him not to get too deep out of his own pocket since I theoretically still have a window of recovery, and if I do recover I'm dropping the suit. I'm not going to claim an injury I no longer have.

That said, the Mayo's take is lumbar arachnoditis, which basically means scar tissue has entwined itself permanently around a clump of nerves, compressing them. It is not operable or treatable. I'm fortunate in that for some people it's excruciatingly painful, but mine is not, just the loss of sensation and function.

If that's the cause, then chances are it's not a matter of waiting for the nerves to heal. The next step legally is to send the records and films to an independent neurosurgeon. If his (or her) opinion is that the standard of care was breached, we have the basis for a case. If not, it's over. Honestly, if this really was dumb luck and not a breach of the standard of care, I'd feel better just knowing that.

Bmwvsmbz

I admire-and respect your opinion , and how will you orchestrate your words . I truly wish you a speedy recovery , and I hope you make millions from them, and buy the S65 and tell us all about it .

mnje350

Wow, thoughts and prayers Mike. If it comes to litigation and you are successful in that venture, I know you will not have won. It won't bring your former life back. Sitting in a new S65 will be a comfort but probably not as good a replacement for what you have lost. I hope you are able to recover and I wish the best outcome possible. What ever that may be.

mrbobby

I know where you are sitting.
I haven't given up and don't intend to, but I may have to come to grips and realize the future is going to be a little different.
I wasn't that good a golfer or tennis player so if those games suffer, so what.
Fortunately or unfortunately I'm somewhat older than you, so at my age, I have to realistically understand and accept some changes in my last 10 or 15 years.
The law suit win may provide satisfaction and some justice to a surgeon who screwed up, but unfortunately won't change your position. You don't sound like a moaner or groaner and I'm sure you'll continue to come around and continue your life much as before but with some modifications to ameliorate the situation as much as possible. Good luck Mike

MBNUT1

So I was on a jury for a malpractice lawsuit. We eventually found for the doctor.

A women had gotten a hysterectomy and ended up with a fistula between her bladder and vagina. The initial play by her attorney was to convincingly paint the doctor as an uncaring scoundrel. He presented another doctor who had treated her later who felt so bad about her condition that he cried on the stand. (She was later treated subsequent to the initial surgery and recovered).

The problem with the case was when the doctor's attorney presented other doctors the whole picture painted of the uncaring doctor unraveled. He had done many of these without incident and there were mitigating circumstances (previous surgeries) that may have contributed to her issues so it was difficult to clearly come to the conclusion that the doctor had been negligent.

All of the other juror's but one didn't think that he was negligent. The one ultimately indicated that she was going to rely on my opinion of the matter. Quite frankly I was sick from the stress of it all.

When the judge came to talk to us he said, " I could see how you came to that conclusion". The way he said it led me to think he may have seen it differently. I later discussed this with my girlfriend at the time who was a nurse and knew the doctor and she assured me that we had come to the right conclusion. Personally I think that women's lawyer would have done a better job if he would have focused more on educating us on the standard of care and providing evidence that the doctor's actions had met the definition of negligance rather than the emotional appeal which at the initial part of the trial was very effective.

I think the takeaway is and it may not all be applicable in your case is that these things can be muddy and subject to the vagaries of other peoples judgement.

Mike5215

All true. Roughly 85% of medical malpractice trials result in defense verdicts. Jurors tend to hold doctors in high esteem. The mechanism of the injury may require a complex, technical understanding that's difficult to explain to the jury, and of course the doc may have actually done nothing wrong.

But the vast majority of cases never see trial because the insurance company and the plaintiff settle. The ones the insurance won't settle are those they feel confident they can win at trial, or cases where they and the plaintiff are so far apart on valuation there's no alternative but to try the case to verdict. (As a juror of course you'd have no idea what kind of money the insurer offered before trial.)

There are a lot of incentives for both sides to settle. Trials are expensive. Juries are unpredictable. For the plaintiff there's a risk of a defense verdict (and the possibility of owing the insurers defense costs in some instances). For the insurer the risk is getting hit with a seven figure award when they could have gotten out a year ago for half that amount.

My doc isn't a bad doctor (or a bad guy), but he definitely had a bad day and I may be paying for it forever. The peer review could very well exonerate him, and I'm okay with that. Stay tuned.

Mike5215

An update. Turns out the doc kind of IS a bad guy. No change in my condition at all. Big change in the scope of the case.

Ever since the med mal attorney agreed to look at the case back in late 2015, I signed some med auths for him and left him alone. He was to order the records and then get them to a neurosurgeon for a peer review to see if there was any malpractice. My contact with the guy was via a customer of mine, also a lawyer, who I let find me the malpractice attorney so my customer would get 25% of whatever the malpractice guy got in terms of the fee. No benefit to me other than a big solid for my customer.

Every few weeks my customer/lawyer would update me on what the med mal attorney was doing. He got the records in and they were three inches thick. He sent the records to not one but two neuros, just waiting to see if either of them was willing to sign an affidavit so the case could move forward. He's got a conference call scheduled with the neuros.

Finally, after five months I just called the med mal attorney directly. Yeah, he hadn't done anything. The hospital wanted "a fortune" for the records so he just ordered the surgeons records. (since we all thought the hospital was off the hook and it was the surgeon if anyone who screwed up, it wasn't critical to have those records anyway.)

The neuro wanted $5,000 for the record review and my lawyer wanted to find someone cheaper. He was real sorry and he'll get right on it. Then he did actually find a guy who would do it for $1,250. That guy did a summary review and said he didn't think there was malpractice. Tearing the dura is a known and accepted outcome, just bad luck.

At that point I parted ways with the attorney on good terms, and asked if I could have the minimal records he did order. Then I read those records and within an hour I had the case blown wide open, and a clear cause of action against not only the doc, but against the hospital. Here's why:

My operation was at L5/S1, the last vertebral level. My conditions, loss of pelvic sensation and loss of bladder control, are consistent with Cauda Equina symptoms. Nobody had diagnosed Cauda Equina Syndrome, but that seemed to me to be the injury. CES is a permanent nerve condition caused by pressure on the CE nerves, which control pelvic sensation and bladder/bowel control. If the pressure is left untreated for more than a few days, the effects can be irreversible. Failing to diagnose CES is a big deal. The last jury verdict on failing to diagnose CES leading to permanent injury was $2.5M.

However, the Cauda Equina is nowhere near L5/S1. It's up a few floors at L3/L4. Plus I read the op report and the doc describes how minimal the instrument slip and tear was, how it caused a "gentle tug" on the dura, didn't get into the exposed nerve root at all, and the only reason they even realized the dura had torn was when cerebro-spinal fluid began to infiltrate the wound. None of that would cause a CE injury.

Then I read the second op report, where they inserted a metal needle into my spine to rig a temporary lumbar drain. The drain was necessary to keep the patch on the torn dura dry for a few days while it set. And that lumbar puncture and drain was right into the Cauda Equina at L3/L4. We were looking in the wrong place. The torn dura wasn't a problem. It was the drain. Which put the hospital on the hook. Here's why:

A couple of days after the surgery I realized my pecker was numb. I told the attending doctor, a hospital employee, about it on the afternoon of 5/7 (surgery was 5/4). He stated he could "take a look at it for me but he wouldn't know what he was looking at." He did no exam, and he didn't order a neuro consult. Nothing.

Later that evening I farted and was amused that it only came out of the right side of my butt. Then I realized that made no sense and started poking around, and I realized my whole left trunk area was deader than dead. Like when you get Novacain in your lip at the dentist and your lip feels like a foreign body. That, but like having a softball crammed permanently up your ***.

Alarmed, I shot a quick text to my wife along the lines of "Hey, remember earlier today when I told the doc about by numb junk? Well it's way worse. Can you check my post op instructions to see if it's normal?" She called back and said it wasn't. I Googled the symptoms and it sounds like Cauda Equina, which would necessitate an immediate MRI and an urgent surgical decompression. Now I'm totally freaked.

I grab the night nurse and ask if he can call for an emergency neuro consult. He said, over his shoulder as he walked out, "Neuro doesn't work after nine pm". Never saw him again.

Early the next morning I told my surgeon. He said it was probably just post surgical swelling. He did no examination, and ordered no tests. However I relaxed since he clearly wasn't worried.

The next day they pulled the catheter and I realized I couldn't pee. That, plus pelvic numbness, is textbook CES. I told my doc, and he still did no exam and ordered no tests. He discharged me the next day with a pee bag and in the discharge summary writes "The reasons for the pelvic numbness and urinary retention were not forthcoming"

No kidding doc! Maybe try to figure out the reasons before it's too late. Nope. I see the doc every couple of weeks for follow up. Every time, he's stumped. No idea what's happening. Probably just temporary nerve trauma from the surgery. He's very hopefull.

But in his internal office notes, which I now had a copy of, his diagnosis the whole time had been "Post surgical CF leak/Cauda Equina Syndrome." Which was actually a huge favor because from a litigation standpoint it takes any confusion about the injury off the table as a defense if the primary defendant does the diagnosis himself.

So in all likelihood, the lumbar drain was positioned in a way that compressed some Cauda Equina nerves and eventually caused irreversible damage, and the hospital and doctors ignored the symptoms and my repeated complaints until it was too late. Failure to diagnose CES. Not good. Pisses jurors off.

With the case basically gift-wrapped I contacted the largest plaintiff law firm in Florida and within 24 hours they had an investigator at my office and signed me up. That's where it stands as of today. Waiting to get all of the records and for the preliminary review. (They have their own docs on staff.)

If you're thinking maybe neither the first doc I told, or the nurse, bothered to document the complaints in their notes at all, leaving me to prove I ever made the complaints in the first place, I saved that beautiful, time stamped and dated text to my wife.

xpl0sive

just one question for you... has any doctor/neuro/nurse or anyone with medical training confirmed that it is CES? I would think that the condition needs to be confirmed prior to the lawsuit.

I read that you said your doctor's notes were related to "Post surgical CF leak/Cauda Equina Syndrome", but it doesn't sound like there was ever an official diagnosis...

Mike5215

Well, given he's the neurosurgeon who performed the surgery, and for whom neurology is his specialty, that determination by him should be plenty. He's eminently qualified to diagnose CES. I'm sure his defense attorney is going to wish he hadn't put that in a report in writing.

But, I did go to The Mayo Clinic for a full work up, including nerve conduction studies and I have my first visit with their Neuro Muscular specialist in April (took six months to get an appointment.) I don't think the diagnosis of CES will be tough to prove. The mechanism of injury and the nature of the injury are entirely and uniquely consistent.

The real problem for the hospital is trying to disprove anything, since they did nothing to evaluate, diagnose or treat. When you have a patient in ICU for a week after a botched 2 hour outpatient surgery, and he's complaining of unusual neurological symptoms, you do an examination. If you're not qualified you find someone who is. If you can't find them, you call the surgeon at home. They literally did nothing.

Not that I think my case is worth $2.5M. That case involved a 19 year old girl, who lost not half of the sensation in her pelvis like me, but all sensation, plus full bladder and bowel incontinence. She's likely got a urine collection bag and a colostomy bag. Still, I have no sensation in half my *****, *******, or anus. Sex is a non-starter. And I have to shove a tube up my pecker four times a day to pee, probably forever. Still likely a seven figure claim once the medical expenses, future medical expenses (Caths alone cost me $700 a month), loss of consortium for the wife, and general damages for loss of enjoyment of life...

We'll see. I'm cautiously optimistic now that I have a handle on the mechanism of injury. But Florida throws up a lot of hurdles.

DaveW68

I wish you the very best with this case my friend. It will for sure be a long and arduous process and will likely take years to be settled....which really sucks. I also hope and pray that you begin to recover and get sensation back over time.

Mike5215

Thanks Dave. We're expecting the long haul, and I don't have any sense that anything is changing neurologically since I was discharged. On the upside, my wife thinks that maybe an expensive bathroom remodel might take some of the sting out of me not being able to bone her anymore. What a trooper, right?

mercedesbenzs55

Wow Mike, I'm glad you reopened this thread. I had no idea you were having these troubles. Are you at the least ambulatory and able to lift?

I should probably cut out the old man jokes. As I read this thread I was hoping you regained some of your sensation. What happened that necessitated you needing the surgery in the first place?

Mike5215

Oh, here's the best part: Turns out I didn't! I had an area of discomfort on the outside of my left heel, and my doc thought it was from the disc pressing on the nerve. I asked about doing a diagnostic nerve block test first to confirm the disc was the problem but he insisted it was a waste of money. Still have the same problem, but now with 50% less dick!