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State11/19/2004
ned the process of degeneration.
Q: Can you say to a reasonable degree of medical probability that the heavy lifting caused the disk degeneration process to begin?
A: No. I believe the disk degeneration process begins from the time we're born and go onwards. However, any injury or chronic repetitive activities can hasten or cause this process to occur more rapidly.
Dr. Stanfors-Dacre formed other opinions as a result of her independent medical evaluation of Parrish (emphasis added):
A: He seemed to be suffering from both cervical and lumbosacral chronic back pain which seemed to be causing some radiculopathy, meaning that he had some residual weakness and some sensory changes, as I noted previously.
And he has had numerous-according to the medical records, numerous invasive techniques, particularly to the lumbar spine. And he does not seem to be in much improved condition despite all of the interventional work that has been done on him.
You know, he basically is, in my opinion, going to suffer from chronic cervical and low back pain because of all the changes that he has had, both from, you know, the labor side of things as well as from the interventional, which can cause scar tissue and so forth and a change in the bony architecture of the spine, both in the spine and lumbosacral regions.
Q: Do you come to any conclusions regarding the likely cause of his present back condition?
A: The conclusion would most likely be due to the fact of the chronic repetitive heavy work that he had done from the time of 1976 onward, as I noted under the vocational history, and his symptoms would be most consistent with chronic wear and tear to the spine.
Q: Did you relate his present back condition to any one specific incident?
A: I did not.
Q: Okay. I note your report says that-and I'll quote from it-has a high probability of being directly-excuse me. Let me go back and make sure I get the whole thing.
Mr. Parrish has chronic cervical and lumbosacral back pain which has a high probability of being directly correlated to his work history of chronic heavy lifting.
Could you give us the basis for that conclusion, what facts you found that would support that conclusion?
A: This was based upon the radiographic studies, the necessity of cervical surgery, lumbosacral surgery and those types of things. And the findings again are most consistent with chronic wear and tear type patterns of the cervical and lumbosacral spine.
Q: Is what you found in your examination and in your review of the medical records consistent with the vocational history which he reported?
A: It did appear to be.
[ ] Parrish testified that he did not know if he was doing enough heavy lifting where he was sore at night, when he started working for Excal in 1994. During his employment at Excal, his neck and back would be sore, "but it had been like that for 20 years. It was just normal." In early December 1999, Parrish saw Dr. Robert A. Narotzky, a neurosurgeon, for treatment of his lower back; about this visit, Dr. Narotzky's medical record reveals:
He has had difficulty with this lower back since 1997. He has had intermittent low-back pain for which he has taken Toradol on a very infrequent basis. Beginning two weeks ago, he had been bending at work and developed severe pain in his left leg with pain that radiated into the anteromedial thigh and medial calf.
(Emphasis added.)
[ ] Parrish denied ever telling Dr. Narotzky that he had been bending at work and developed severe left leg pain t
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