Short Term Gain and Long Term Losses

It is not the standard of care to perform a bone density test on a woman that has:
1) had multiple broken bones in adulthood
2) received numerous steroid blocks spine blocks
3) gone through menopause at an early age
4) now facing cervical spine surgery at age 57.

All of the above were indicators that were ignored prior to my spine surgery in 2004.

Should it be the "standard of care" know that all of these factors play a significant role in the bone density of a woman past the age of 50? I think so.

Our local hospital began doing bone density tests in 2000. Articles have been published nationwide regarding the factors listed above that make women a high risk in developing osteoporosis. This past week I went for my yearly density test and find that 7 years after beginning the testing that there is now a simple form to be filled out by the patient on bone health. A one page form that is filled out by the patient that would trigger any "red flags" regarding the known risk factors mentioned above.

It should come to no surprise to anyone that when I underwent surgery at age 57 that my bones resembled swiss cheese. The surgeon was unable to anchor the screws into my bones with any certainty that they would hold and stated later during the day or surgery. Two weeks following the surgery the screws shifted and the surgery collapsed.

Who exactly given my background is in error? My GP that had never ordered a bone density? The surgeon who operated not knowing the condition of my bones? Why is it not within the "standard of care" 10 years after knowing the factors contributing to osteoporosis?

Of course, immediately I was sent for a bone density test. This was only after the collapse of the surgery and after the surgeon had continued to perform the surgery after witnessing the state of the bones. The bone density showed severe osteoporosis.

Why then would a surgeon proceed with the surgery? Would you remove a gall bladder from a patient that once you opened them was shown to have cancer? Why would you risk the shifting of these screws and immediately want to schedule another surgery to "stabilize" the first?

The only answer I can come up with is money! You get paid twice for two surgeries! There is no warranty on you errors. The surgeon will never say "this one is on me" and I will not bill the insurance company twice since this was my fault!

If he had simply closed the incision and stated that my bones were not good enough to perform the intended surgery, would he have not gotten paid to do the surgery? Probably not.

Meanwhile, the screws have shifted into adjacent disc spaces and as the bones worsen with age will become more and more of a problem. I live with being one fall away from not walking.

Where does the best interest of the patient play a more important role than money? What about the Hippocratic oath?

I vote for bone density test to be performed prior to any spine surgery and that become the National Standard of Care adopted by the AMA.

Mary Riggs is the Owner of Cute as a Bug Boutique in Hickory, NC http://www.cuteasabug.biz

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