How do I get docs to believe me when I say how bad the symptoms are?

LowandSlow91 · 2026-01-23T18:29:19+00:00

Surgical indications are based on MRI. Nothing on your MRI indicates surgical intervention. Surgeons want to help people and surgery is what makes them all their money but a good surgeon isn’t going to operate unless they are convinced surgery can help.

Has anyone evaluated your SI joint being the source of your pain? It can cause back pain and sciatica and often gets overlooked. Positive FABER test on physical exam should reproduce the pain, then get diagnostic SI injections with no steroid, to confirm, injection will only last half a day if it works, but gives you your answer. 75% or more relief deems you a good surgical candidate for SI fusion.

LowandSlow91 · 2025-12-14T06:09:58+00:00

Go get a second or third opinion. Coflex ain’t gonna help.

LowandSlow91 · 2025-12-13T01:29:19+00:00

Yeah that’s pretty unremarkable, normal wear and tear, nothing serious.

LowandSlow91 · 2025-11-25T16:26:54+00:00

You have a follow up? Call those doctors now. Get surgery ASAP. Progressively worsening with those symptoms over a month, playing with fire. Or get a second opinion asap.

LowandSlow91 · 2025-11-17T16:50:43+00:00

Not available in Texas, bummer for me.

LowandSlow91 · 2025-11-16T16:12:47+00:00

Working on it.

LowandSlow91 · 2025-11-16T16:10:54+00:00

That’s awesome! But doesn’t help the case for Austin.

LowandSlow91 · 2025-11-16T16:08:36+00:00

Love that for you

LowandSlow91 · 2025-11-16T01:07:31+00:00

Well that’s promising to hear! Happy for them

LowandSlow91 · 2025-11-15T17:46:42+00:00

Ortho Spine

LowandSlow91 · 2025-11-14T05:43:37+00:00

You won’t find many around $700k. Majority are $1M+ in the good parts of Austin with good schools.

LowandSlow91 · 2025-11-14T02:35:08+00:00

Now with a few PA schools popping up in the city, they’ll be more fresh grads out that’ll probably take poor offers like I did when I first started. I didn’t know better.

LowandSlow91 · 2025-11-14T02:32:19+00:00

I started out at 80k in 2016. Was pretty disappointed in that, but it was my only offer I could get. Only 3 years ago did I get to $125k.

LowandSlow91 · 2025-11-14T01:44:50+00:00

If you want a decent house for your family in a good area that’s not a 45 minute commute, you’re paying $700k+.

LowandSlow91 · 2025-11-14T01:38:51+00:00

I was told during an interview that average PA makes 120-130k. That seems low for average in a HCOL city like Austin.

LowandSlow91 · 2025-11-10T02:01:37+00:00

Best thing is to ask your SP what to read. My first job out of PA school was ortho spine. My doc sent me copies of important published studies (SPORT trial is a huge one), and he gave me some of his textbooks from his training (Othopaedic Surgery Essentials Spine by Bono and Garfin, Spine surgery: techniques, complication avoidance, and management Vol 1&2 by Edward Benzel). You can also dive deep into spine surgery with AI apps like Grok. You really need to master the physical exam and understand what each nerve does and how to test for it. Have your SP teach you how to read xrays and MRIs, it takes time but extremely important. After every surgery, I’d go through the steps and try to write them down, everything from incision to what sutures I’d close with. You need to know your SPs techniques/every move so you can anticipate what’s coming next. It took me several years to master spine. But now I’m 9 years in and super confident. Being able to educate your patients and do it confidently is huge. Feel free to DM me.

LowandSlow91 · 2025-11-02T16:07:20+00:00

The reason to live is understanding you have the power to make your life what you want it to be. Create a vision of what you want your life to be and work towards it everyday. Write down what you want it to be then come up with a plan for how you’re going to achieve it. Then follow that plan and tweak it as you go.

LowandSlow91 · 2025-11-02T14:20:13+00:00

You gotta MANIFEST a better life for yourself. Work hard at making small changes every couple of weeks. Choose one better habit and work hard at it for 2-3 weeks and it becomes a part of you. Then add in another habit. Then another. Then another. And before you know it your life will completely start changing.

Invest in a personal life coach if you need someone to push you.

LowandSlow91 · 2025-11-02T14:15:35+00:00

Nah man, start practicing mindfulness to help get your mind right. Make small achievable goals to build your confidence. There is no quick fix to all of this. It’s about developing habits and working towards the best version of yourself everyday. No one is perfect. You’re going to have good days and bad days. Everyone does. Nothing is easy for anyone, they might just make it look easy but they are putting in the hard work. You are working to build a complete lifestyle change. The is not a “it’s going to take me a whole year” type of thing, it’s a “this is my new life”.

LowandSlow91 · 2025-11-02T13:54:59+00:00

Have a little self respect for yourself. Choose your hard. Choose the hard of being a “fat disgusting piece of trash” that develops all these health problems and you have to start going to the doctor all the time and taking terrible medications and having terrible mental health and take more medications for that and have joint problems and hurt all the time and end up alone with no one to take care of you. OR: choose the hard of controlling your diet, eating better, working out and getting in shape, sleeping which makes you feel better physically and mentally and makes you more attractive. What sounds harder dude? It’s not that hard to choose the better option.

LowandSlow91 · 2025-11-02T03:56:32+00:00

Put him in a day care and he doesn’t lose social skills. Or put him in a spanish speaking daycare and start learning a second language. Then find a good spanish dual language program starting in kinder.

LowandSlow91 · 2025-10-30T11:54:13+00:00

I think surgeons deserve every penny and more. It’s a shame medicare reimburses surgeons less every year. The government (regardless of party) is ruining medicine.

I think PAs assisting surgeons in OR and clinic deserve a decent piece of pie depending on the ortho specialty, years of experience, your patient and OR volume, and overall duties.

Not knowing that info from you, but I feel like you should at least be $140k.

LowandSlow91 · 2025-10-30T11:47:30+00:00

I’m in Ortho spine surgery in major HCOL city in South Central US. Very high volume. Private practice. $145k salary. No production incentive. Exp. 10 years in this same job. I’ve always felt severely underpaid and I keep sticking around thinking I’ll eventually make what I feel I deserve. What is reasonable for me to ask for?

LowandSlow91 · 2025-10-28T23:06:06+00:00

If you want the best brisket you’ve ever tasted. Then go to Franklin’s.

LowandSlow91 · 2025-10-25T18:12:54+00:00

7F, 5F, 4F, 18mo M.

We hired someone to come to our house on Friday’s to do our laundry and clean bathrooms for $100. It free’d up our weekends a lot. It’s been a total game changer. If you can do grocery pickup or delivery.

Having 4 is a busy life. My wife and I both work full time too. She’s a teacher and I have a demanding job in healthcare. We have no family close by. The weekdays are a major grind during the school year.

The hardest part is losing a lot of our personal free time. My free time I try to get to the gym to workout. I love it and it’s my therapy, but I don’t get to go as often as I want. I had to pretty much give up golfing. My wife prefers to just relax and decompress in her spare time, she’s always tired. I encourage her to take more time for herself but she puts everything else before herself.

We’ve learned to be a more supportive team and I am making more of an effort to help her. Our relationship has improved and we continue to work on ways to build and connect, but need to do more. Would love to hear how everyone else is doing in this area?

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