Need advice

[brattybratteddi]

First off I will start out with a little bit of history on my low back pain. I have always had chronic back pain as I am well endowed as a lady, am considered as a dwarf because I am only 4'8 and also because of a few auto accidents. In January 07, after I had suffered a heart attack at 37 in Noveraber of 06 I was sent to do a stress test. That evening I had gotten off of the computer and went to go to the bathroom and had severe pain in the arch of my left foot I couldn't put weight on it and had to walk on my heel. I did find out during the time of this healing that if I put my foot flat on the ground and shifted my weight a bit I could walk normal; but still would have a pulling stretching filling in the arch of that foot. I had talked with my doctor is regarRAB of this and she gave me flexirils, and vicodin for the pain. Since this time, my low back started to hurt and remained on these meRAB for my back, however where they would work for me and give me relief this wasn't even touching my pain and would barely if at all would take the edge off. So my dr. had change different meRAB, tried to get me to go to PT, but PT isn't covered by medicaid.

For a while I started to see a chiropractor which also normally would help me out and give me relief manual manipulation didn't work for me either. Now getting very frustrated not only of my back and the pain, but with the medical professionals because we weren't finding any answers. By now I had 3 sets of low back x-rays and not much showing up on the x-rays. I was sent to an orthopedist surgeon who re-did the x-rays again, changed meRAB again; he had decided to send me for an MRI. MRI and showned a herniated disc., DDD (mostly stage 1, and some places stage 2 and 3), some normal, non cancerous cyst and a bulging disc. I was then sent to a nero. surgeon who had suggested a lamenectomy, and possible spinal fusion and spinal epidurals to relieve the pain; however this dr. would be leaving the practice soon and refer me to 1 of his partners because he was leaving the state. This dr. however; didn't do anything though he did accept medicaid, he didn't treat patients equally and was painfully apparent. He also suggested an epidural, and PT; he wasn't able to do the epidural in his office and blamed the pain on the fact I am slightly heavy. Getting more frustrated as the pain is now getting worse by the day (literally and not exaggerating). I had decided to see a sports medicine doctor as by now in June of 07 the pain had now spread on both sides of my hip as well as the low back pain. This dr. agreed that surgery wasn't needed at the time and thought that I had fibromyalgia and that is the cause of my pain. So we changed meRAB. once again and nothing still pharmacuetical isn't working and for what little relief I may have would just barely take the edge off and that is/ and was just barely at that. He too suggested an epidural and again, not able to do it in the office. I was then referred to a pain management special in August of 07, however; he wasn't accepting any new patient until after the 1st of the year. Unfortunately there wasn't any other pain specialist that would accept medicaid and primary dr. couldn't send me to anymore specialist at this time. By this time, I had started to have pain in low back, both sides of my hips, tailbone and both sides of my groin; and also now starting to have nurabness and weakness in both of my legs. I could and still can't walk or stand anymore than 2 minutes if even that without the nurabness and weakness starting. The pain in my low back and hips is sharp, stabbing and burning sensation, (if I stood or stand outside of my now 2 minute window, while having nurabness and weakness in both legs (no pain yet in my legs).

Finally getting my appintment with the pain specialist in March of 08 he agreed with me he didn't think it was fibromyalgia, or if it there is fibromyalgia, it isn't just fibromyalgia. He had wanted me on Kadian, ES vicodin and meRAB to help me sleep. Kadian isn't covered by the insurance, nor was the sleep medication, so I then started with MS contin, and ES vicodin for breakthrough pain. In April of 08 I finally had a medial branch block injection which didn't work so was again sent to another orthopedist that specialized in hips to get an MRI of my hips trying to figure where the pain is actually coming from as I am now having more pain my hips and still the medications aren't working for me. This MRI didn't show much in my hips cept some bursitis. Now taking the MS contin 2x's daily and the ES vicodin regularly the pain is getting worse, now starting to have pain in my thighs and both knees (by this time I had actually lost 50 lbs.) and the pain was still getting routinely worse. Pain is severely limiting any mobility and now have started to use a motorized scooter to get around bigger stores, and a cane to get around shorter stores. Also now completely unable to work because of the pain.

Today I had gone into a dicsgrogopathy (this procedure seriously sucks hurts like a dickens and you are awake during the procedure as they need you to be awake and able to answer questions because they are trying to simulated the pain). It is confirmed that I have 3 bad disc in my back and now is being recommended on getting a discectomy. Next Wednesday we are suposed to talk about the procedure more in detail as they couldn't by law discus it in detail because of the little sedation that I did have. (BTW, for what I did have, didn't make any difference as I was awake, and I am still dealing with the pain (made worse) even 12 hours later. LOL.

My question is ultimately does any one have any suggestions or comments for me in regarRAB to the discectomy, what to expect? Should I go for it? What are the benefits? What is recoverly like? Would or will I regain some of my mobility? Or atleast decrease the constant pain that I have everyday and is still getting worse as the days go by? I am really concerned as the nurabness, and weakness is getting worse rapidly including today getting ready for the procedure picking up my clothing from changing into the hospital gown my hip had rolled and popped and now it gives me extreme pain straightening it, or bending it. Dr. has suggested that this is due to the 3 bad disc. I am concern about any possible permanet damage as there has been so many delays in dealing with this and seeing my mobility daily decreasing and symptoms increasing and window of tolerance decreasing daily. I am scared and very concerned about this.

Should also mention that since this has been going on my back and hips are always warmer than the rest of my body regarless on statis of clothing being on or off. I can't stand nor walk anymore that 2 minutes. Can't sleep as sleeping on stomach or back bothers my back, can't sleep on sides because of pain in my hips so I am constantly tossing and switching throughout the night, and often wake up in the process. The only position I am somewhat comfortable in is sitting and even sitting I am constantly fidgeting and changing positions because of my back. There are days that my back really feels as though it has frozed or stiffen and makes it really hard to get up out of bed and the stuck feeling in bed is happening more often.

Sorry that this is very long, but I had wanted to include as much information that I could so you had a better idea of what I am going through and welcome any advice that anyone maybe able to provide or give me. Thank you.

 

[mznell]

Hello brattybratteddi,

Welcome to the board. I am sorry you have been having increasing pain, with few answers, for such a long time. We all can sympathize with you, having gone through similar types of problems with our backs/spines.

Despite your detailed post, there is still important information that we don't know. It sounRAB like your pain is most probably the result of the pain associated with the disc herniation. Nerve roots are being compressed, either by disc fragments pressing on them, by inflamation, etc. The pain you feel in your legs, feet, hips is most likely coming from nerve roots in your lower lurabar spine.

The fact that your pain is increasing and that the time you can stand or walk is getting shorter in duration is probably directly attributable to the amount of nerve compression you are experiencing. The more inflammation you have, the less room there is for the nerves to pass through. With the DDD you may have some areas where the bony overgrowths are pressing into the central spinal canal, which also limits the amount of space through which the nerves must pass. To help visualize what is going in, think of a garden hose. When it is clear the water can flow through unimpeded. If it becomes clogged with mineral deposits, etc. the interior space is greatly reduced. If it is almost totally clogged, the water stream is reduced to a tiny trickle and can barely pass through. This is the same with the central canal space. If you have arthritis, ddd or if there are pieces of discs in that canal, the space where the nerves need to pass through is narrowed. The nerves can get squished or compressed...and this causes a great deal of pain.

This is a vicious circle. The more inflammation you have, the less room there is for the nerves, resulting in more pain. Depending on the location of this problem, the pain will radiate out to your hips, down the back of your thighs, calves, into the feet and toes. Depending on location, it can radiate to the front or the back of thighs, calves, feet. Each lurabar nerve root refers out to a specific location in your lower lirabs. ( You can look up DERMATOME to locate a chart that will show you the direct relationship between nerve root and location. )

When you go in to talk with your doctor, you need to find out exactly what he is proposing. Is he recommending a discectomy on 3 discs? If so, will a fusion also be necessary? If not, will your spine be stable enough to support you? Are there alternatives to surgery?

You have a week until your appointment. I would suggest you do some research on the internet and learn as much as you can before you go in. Read up on disc herniation, lurabar radiculopathy and discectomy.

Also, be sure you are going to a doctor who specializes in the spine and back. You do not want to go to an orthopedic doctor who has a general practice, meaning he/she also deals with hips, broken bones, joint replacements, etc. Spine surgery is a very delicate procedure. You want to go to the person who is best qualified: this will be a fellowship-trained spinal surgeon (either an orthopedic surgeon or a neurosurgeon).

Sorry this is so long. Hope something will help you to better understand your issues.

xx M:wave:M

 

[brattybratteddi]

I won't know for sure which of the 3 disc that they found were bad until I see the doctor next week however; going over the diagram from the chiropractor who had given me the diagram and told me my trouble spots had thought to look at it again and share this information for anyof you fellow back pain sufferers can maybe offer me some advice of what may be expected, or questions to ask when I see the doctor next Wednesday.

Since the procedure was done for the low back, and hip pain I see that on the diagram the chirpractor had highlighted L4, L5 and the Sacrum and I am thinking these are the problem disc in question based on the procedure done yesterday. (which again must say was a really painful and icky procedure hoping not to go through that again).

Mid back
The problems areas are the T1, T2, T5, T6, T9 and T10

Neck Region and upper back
The problems here are C1, C6 and C7

So I can say I do have problem areas all through my back and have been in extreme pain constantly going on close to 2 years now and is progressively getting worse.

I am a bit concern in the decrease in mobility and wondering of any permanet affects or continuing pain even after they do surgery. When they are talking fixing the problem are they talking fix, fix. Or talking fix, but still will have pain but may be more controlable. I am unable to work at this point because of the pain, and increasing mobility problems. I have resorted to using a cane to help aid in walking and use a scooter for longer larger stores, going to museums, zoos or other things so not to try to miss out on a lot of lifes little pleasures and do things with my son. My son is 9 and my pride and joy and I do seriously try to do as much as possible so he doesn't miss out on adventures and fun things because mom's pain. Also am wondering if I can get back into the workforce and be more productive in life instead of just trying to coexhist in society. Or if this will totally end up disable me. I get tired of the looks when I park in handicapped parking areas because people don't see me confined to a wheelchair and that I am young. Or the glares because I use a scooter and they feel I am just overweight and lazy and rather sit instead of walk around the larger stores. I do have a handicapped placard, so am not parking illegally and do have my own scooter though at times because of what is intended to be purchase do leave it at home and use the stores so we have room for our intended purchases.

The DDD is in Phase 1 and showing signs of stage 2.

Also should mention that there is nerve damage of the sciatic nerve because of being inflamed or being pressed/pinched a result of the problem areas. So am concerned of long term permanet damage of the nerve and what possible prognoises or long term affect I should be aware of. Limited mobility permanetly and what not.

 

[mznell]

No one can tell you if the nerve is permanently damaged. And it is even hard to tell after surgery as nerves heal very, very slowly. Some doctors say it can take up until 2 years to tell if the nerve is going to rejuvenate.

Regarding surgery, there are no guarantees here either. Even the spinal specialists do not know what the outcome will be when they perform surgery. They will give you "the odRAB," but they will not tell you how your surgery will turn out because they just do not know. Back surgery is not like removing an appendix or a kidney stone where the outcome is pretty predictable. I have a wonderful surgeon that I have become frienRAB with. He was telling me that he has done surgery where he felt it had gone fabulously, perfect in every way, and the patient developed foot drop a week later. Other times he has had a badly compressed nerve where he and his assistant have had to tug and pull on the nerve to free it up -- manhandled it badly--when he expected there to be damage as a result, and the patient's surgery turned out perfectly. Just as you can't look at a MRI and know for sure where the pain is originating, you can't know the final outcome of surgery ahead of the procedure. It is a garable. That's why it is so important to do everything you can to avoid surgery, and then, if it is the only option, do your homework so you know you are going to the best doc for the job!