Need your opinions. Sorry so long

[BooBoosNeck]

Here is my background: I was injured in a fall at work last Sept. I have had an x-ray of my head, ct of my head, mri of my neck and an emg on my hand/arms/wrists. All of the doctors I have seen (except for when I went to er) have been wc doctors.
I broke my nose in several places and since they did not set it right away, I need it to be re-broken and set (OUCH!).

I suffered a concussion. I re-injured (I had two car accidents that had previously caused some damage to) my back and neck. Luckily I had MRI's from when it was previously injured! With the exception of T1, I have herniated discs from c2 through t3, I also have ddd and arthritis in my spine. I suffer horrible headaches, and in addition, I now have CTS from when I fell.

Here come the problems. A NCM was assigned to my case a few weeks ago. She thought in the beginning she would be going into my appointments with me, no way. She comes in and speaks with Dr AFTER my appointment with him. I do not think she is a bad person, but I have real problems with her telling my Dr How he should be treating me. Today she called and said she was going to call Dr and tell him I needed to be prescribed a compound to be rubbed on my back. She also thought it would be a good idea to have a glass of wine to help me sleep. First off, I rarely drink. Second, how smart would it be for me to drink and take all the meds I have been prescribed? She also said I should double the dosage of my muscle relaxers. So, have any of you run into this and how did you handle it??

[1171]

Discuss it with your doctor; they are in a better position to evaluate and handle it. if necessary they can contact the employer/carrier about interference.

[stiffnecked]

Don't answer her calls. She's not a doctor she shouldn't be giving you medical advice such as drinking wine to sleep. If you can't sleep then ask the doctor for some Ambien. Not the CR type. That's a sleep medication and that's what doctors give out.

I just can't imagine your telling the doctor you can't sleep and him saying to just go down to the corner liqour store and get some Mad Dog 20-20.

[jayne]

ahhhhhh come on mad dog was good.......nurse case manager IS NOT A DOCTOR....altho they get a God complex much like a doctor....Speak to your lawyer if she is interfearing with your recovery have the lawyer boot her butt.She is not your friend she wants you back to work ready or not...I suggest you treat her like a timber rattle snake......with respect and distance cuz they can both do alot of damage if allowed to strike

[kate]

Jayne, MD 20 20? Wasn't bad and really cheap. :-)

Boo,

OK here's the deal. Some NCM's are very, very good. I had some on cases where the doc released the IW to work or said they didn't need certain tests and the NCM's reamed the docs (or their nurses when they couldn't talk to the doc) and they finally gave in. Had others that I actually asked to be removed from my files and I would do all their work on my own since they actually made things worse). I also worked with some excellent NCM's who eventually quit because they couldn't handle how they were expected to do their job under WC, which conflicted with their very basic nursing training which was to help the patient.

Jayne's right in a few respects. The NCM is not a doctor. But sometimes they see things the doc doesn't. Sometimes they help. Sometimes, they do ignore everything except getting you back to work.

The reality is, they are paid to do a job and one of their functions is to get you back to work. Most times, if an IW can get back to work as soon as possible, even if in a limited capacity, it is always better for them. Unfortunately, sometimes the "get them back to work to help in recovery" gets whittled down to "get them back to work".

As far as drinking wine or anything to help you sleep, she may be right, it may help you sleep. And then what, it reacts with meds?? or your not even on meds anymore but one glass of wine doesn't help so you have another?? It's called "self medicating" and it's not good under ANY circumstance. I don't know what nursing "etiquette" is but sounds a little unethical to me. (my opinion only)

Double the muscle relaxants??? You were given an RX with a certain criteria for how much and how often. DO NOT take anything other than what the doctor prescribed. And if you are concerend about the interference from the NCM, don't hesitate to mention it to the doctor. He/She should know about it.

I guess you go by a simple rule... If it doesn't sound right, it probably isn't. (talking about the wine thing and double meds thing) Sometimes WC rules don't sound right but they are the law and that's a whole other issue.

[Lilly]

Hi,
I Agree... I would also report her " medical treatment recommendations" to your treating doctor ...her suggestions are dangerous and ridiculous and could put you in danger . Possibly, he'll personally tell her to take a hike! Or even report her for her bad medical advise & interference.
Good luck, Lilly

[capricorn]

boosboos......I am with the group here. You have been given great advice and I have nothing to add. Best of luck.


Capricorn

[BooBoosNeck]

Thanks everyone. I just wanted to make sure I was on the right track. I have visited all eight Dr's they have sent me to and done everything the Dr's have said. Nothing woud make me happier than to feel better and be able to go back to work. You know, it stinks feeling lousy all the time and then having to deal with this stuff too.

[backache]

I know in PA a nurse cannot prescribe or diagnose. It is against the law. This woman has me very worried telling you to drink while you are on meds and telling you to double your meds without your Dr's knowledge. The next time you speak to her ask her if she ever heard of Karen Anne Quinlan? She was the young lady, I believe from FL, who took medication and drank. I can't recall all of the details, but she was in a comma for years on life support and it became one of the first big battles over the right to die issue.

[BACKHURTS]

The first NMC I was assigned came in the exam room with me and told me that I needed to tell the doctor I was ok and wanted to go back to work with no restrictions ASAP because otherwise I could lose my job or be unable to get a new job because I would be labeled with restrictions and most employers will not hire someone like that. I called and complained about her

About a year later I had a 2nd NMC assigned to my case. She came in the exam room with me, I felt very uncomfortable, I did not know that I had a choice. She too told me I needed to take more pain medication...she said that being in pain slows down the healing process. I told this to my doctor in front of her and my doctor told her that she would prefer if she not tell her patients how to take narcotics. I think that she did however help me to get the further treatment that I needed.

The nurse also use to call and check up on me. At the beginning I thought it was really nice then I realized (or think) that she was making sure that I was home. I was in the bathroom once when she called and she left me a message like "Oh since you are in so much pain I figured you would not be able to leave your house" I called back and left a message that I was indeed at home and since I was in so much pain that I could not move quick enough to get to the phone from the bathroom.