Pain & Confusion

L

Live2Love

New member
I was injured back in March in a car accident and have had severe pain since. I go regularly to the Physical Therapist. In May or June my orthopedic surgeon gave an epidural, but when I entered a pain management clinic in June, he wanted to handle all the treatment, but hasn't done an epidural yet. I don't want to just leave him because it took forever to even be able to get into a Pain Mgmt practice..

My pain meRAB however are barely working now. I let him know last month that they weren't working as well, and I've now been pretty much bedridden for the last two weeks due to pain. I have Fentanyl patches and Oxy IR for breakthrough pain and Neurontin to help with some of the nerve pain, but it takes two days of Oxy taken at once just to give me a couple hours of moving around. I can't live like this, I'm barely living as it is. Collecting disability insurance has been difficult because my Pain Mgmt doctor (Anesthesiologist speciality) says he's not certified to fill out disability forms. My PCP says it's because disability forms can be extremely time consuming working with disability groups and filling out the mountains of paperwork they sometimes present the doctor. So it seems like I should find another Pain Mgmt Doctor but it's so hard to get into most of their practices.

I did just get a copy of my MRI from back in May but don't know how to read it very well. It discusses the L4-L5 vertebrae and I can post it if that would help or someone knows how to put it in better terms.

It's been 9 months since the accident but I haven't gotten as thorough of a conservative treatment as I would have liked due to the lack of epidurals thus far. I'd like to avoid surgery if possible because of all the stories from frienRAB and others about still being injured after surgery, or things coming back in 3 years. So I don't know what to do, but am tired of being in such pain and stuck with this helpless feeling for fixing my back.

Thanks!
 
Live, first of all I am very sorry for your suffering. I too have a very bad neck and a neck that is much worse. I had to get disability for my Lupus and it was very time consuming for my doctor, BUT it had to be done. You need this care and you need a doctor to do this for you. I would certainly sit with this doctor and tell him how important this is that you get this done. I know my Aunt had disability send for her recorRAB (she has a bad, bad back) and she got picked up first try which we all know is very unusual.

Don't give up. If you need to seek another doctor, please do so. I don't say that lightly because you are right, it IS time consuming and the change can be hard.
But, remeraber you don't deserve to live like this, and it is hard enough to be in pain without wondering how you are going to care for yourself financially.
I will send up ALL good thoughts for you.
Take care..
Madison
 
Thanks so much. I do have an appointment with a Physiatrist the day after my pain management appointment this week, so maybe he can handle disability better (my understanding is Physiatrists do more with disability cases anyway). I'm also hoping he can present an alternate treatment plan that can get the ball rolling again.

I noticed some people have posted their MRI results and gotten a better clarification, so here I go in the hopes that someone out there can explain it slightly differently.

Findings:
A transitional vertebra is noted in the lurabosacral region, which in this report will be called L5. A broad-based disc protrustion is noted at L4-5. The protrusting disc compresses the thecal sac and compromises both lateral recesses of the spinal canal. The above finding is best appreciated on axial image 15, and on sagittal images 3-9. The height and signal intensity of the disc at L4-5 are decreased. The height and signal intensity of the remaining discs are normal. Small hypertrophic bone spurs are noted in the body of L4 and L5 vertebrae. No other bone abnormality is identified. The distal end of the conus is visualized and appears normal.

Impression:
1. A transitional vertebra is noted at the lurabosacral junction, which in this report has been called the L5.
2. A broad-based disc protrustion is noted at L4-5. The represents manifestation of disc degeneration, although an associates disc herniation is probably also present. The protruding disc is centrally located, compressing the thecal sac. It also compromises both lateral recesses of the spinal canal at L4-5.
3. The height and signal intensity of the disc at L4-5 are slightly decreased. These are other feature of disc degeneration.
4. Small hypertrophic bone spurs are noted in the body of the L4-L5 vertebrae These bony abnormalities are secondary to disc degeneration. They compromise, further, the lateral recesses of the spinal canal at L4-5.

Thanks so much!
 
Just wanted to add Live that when I was first denied by disability, my therapist sent along a letter, and I got picked up within a VERY short amount of time after they received that letter. I never had to go to any hearings about my disability. IT IS true, that they are very helpful in getting us our disability.
I think that is a GREAT plan.
Keep us posted, and I hope you feel better soon...
 
The Pain Mgmt. Doc yesterday is finally starting a round of epidurals which is good news and thinks my pain levels are too high which is also good. I'm worried though since he's taking me off the patch and changing me from OxyIR 5mg 2x a day to Roxy 15mg 3x a day. I'm not sure the increase in dosage will both counter the existing pain levels and also termination of the patch. We'll see I guess. I know my pain is still bad now, but at least I won't have to wait a whole other month to see him with regular visits for epidurals coming up.

I see the Physiatrist shortly which should make things better with disability. Maybe he can explain this MRI reading to me. I still don't understand what it's saying, and the pain doc yesterday didn't explain much but when he did read this he was far more responsive to my pain and epidural neeRAB, so it seems something in it shows something. Hopefully someone here can read it!

Thanks!
 
Relatively good visit with Physiatrist today. They were able to explain the MRI results very well and also showed how the nerves are affected using the MRI. They were also able to fill out disability paperwork to demonstrate at least the next two months.

That's the good part of the relatively good. The bad part was them saying that if a series of bilateral epidural injections do not provide pain relief, then my only recourse is a double laminectomy. The centrally herniated disc that compromises both nerve regions is restricting the nerve space by about 60-80% and doing that for both nerve cavities. So the epidurals may not be effective because of how much space the disc is taking up and because of both sides having a problem is the reason for the double laminectomy.

So.....

If I do end up having to have surgery and it is successful, then will I have to limit activities in the future? More importantly if I have surgery and it ISN'T successful, what am I in for? From what they said repeated surgery isn't much of an option because if scar tissue grows in the area then it will keep growing each time more gets scraped out. The doc today things the pain med levels i'm on is too high, but i'm in alot of pain now and as tolerance builRAB.. ???
 
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