October 30, 2009 - 7:27pm
Hello. I discovered a herniated disk in summer 2008, I just knew something was wrong when my leg was numb/so painful from the syatica. I was under the care of a Nuerologist and he sent for an MRI and was managing the issue with pain meds and nerve blockers. I ended up having extreme, unbearble pain and having to go to the ER and be refered to a Nuerosuergon who took one look at my MRI and admitted me to the hospital for pain management until he could do surgery in a couple of days. So anyway, I ended up having a reputered disk L4&5 - S1 sounds right....I ended up having a spinal fusion in Oct. 2008.
Fast forward to present time. I still see the Nuerosuergon. I take 3 7.5/750 Hydro & Soma 350mg x2 day. I have not worked since the surgery & am in process of applying for SSD.
I have severe pain since the surgery, not the same kind of pain that sent me into surgery but different pain like from Aurithritious & hardware pulling. extreme hip pain and I also have pain that shoots down my legs but it's different than the syatic issue, it's a sharp pain and when I mentioned it to the Dr. he said that there could be "a few disk fragments floating around that could be causing this problem."
I don't lift anything and it takes all I have to keep my house clean. I'm 30 years old and I need more relief. I have no idea what kind of pain medication would help me keep this pain at bay. What I'm taking is only working 40-50% of the time. I live in a cold climate and it's just unbearable in the winter. I'm really just looking for suggestons of what different plans to talk with my Dr. about. He would like me to have a Cat to check the fusion as it will show more than the X-rays but I am currently uninsured so I'm saving up for that. Any sugestions would be appreciated and thank you for reading.
Oh, please excuse my spelling!
October 30, 2009 - 8:45pm
#2
Uhhh, this all strikes me as
Uhhh, this all strikes me as somewhat questionable... So within the short span of a few months, you went from diagnosis to spinal fusion? What happened that made the pan medications and nerve blocks no longer effective -- just an inexplicable increase in pain? Were you offered any alternatives -- adjusted medications, other nerve blocks, physio, etc? The thing is, as I understand it, a spinal fusion is more often detrimental than effective. Regardless, it is a major operation that should be carefully considered, as its implications are by no means transient; if it doesn't work, the patient is still stuck with the outcome. Unfortunately this is the case for you.
The point is that everything seems a little rushed. As hinted above, there are a lot of options of varying efficacy. It seems that you need to pursue those options now, despite and also apparently because of that spinal fusion. I think what your splendid doctor is referring to in explaining your pain is 'failed back syndrome.' In my humble opinion, you'd be much better off if it had been suggested that you first exhaust every treatment option. There's a reason for the term 'conservative treatment;' the name does not mean your pain can not be aggressively treated using the methods involved.
The upside to this situation is that perhaps it will be easier for you to get adequate treatment after going through such a major operation. In this case, since your injury is no longer au naturelle and has been complicated by the surgery, I think the most effective solution would be a perhaps much more substantial pain medication regimen -- the potential solution that should've been suggested in the first place.
I have a pretty bad L5-S1 herniation along with a decent number of other related problems. My first medication treatment was with Tylenol 4s, but 4-6 of them per day did absolutely nothing for the overwhelming pain I was in post car accident. Had a spinal fusion been suggested as the appropriate treatment at the time, I may have been inclined to believe it at that point. Of course, my lower back is now so incredibly rigid that I may as well have had the surgery... Within a few days, I was on 4-6 10/650 percocet per day before I got substantial pain relief. I'm now on 70mg of oxycodone per day. The fact is, your pain medication dosages are pretty low for somebody who was in such severe pain as to need a major operation. So, I would look into increasing your medication dosages in general. In particular, since at least in my case the pain tends to be a pretty constant unwanted companion, I suggest (as I'm sure others will) you eventually look into an extended release medication if you find that dosing with immediate release meds like the hydrocodone/acetaminophen you're on isn't effective.
And if anyone suggests you look into fentanyl, don't listen. 
At least not yet...
Good luck,
Phil
October 30, 2009 - 9:26pm
#3
Talk to your Nuero or PMD
Talk to your Nuero or PMD about Lyrica or Nuerontin in addition to the pain meds. I agree you need an increase from where you are at. I have had spinal fusion and am currently putting off round 2, it was declared an emergency due to cord compression. I will never be pain free and you probably won't either but at the time I was at risk of being paralyzed from the neck down so I'll deal. I find that due to the permenant damage that was done to the spinal cord and root nerves that the medications that treat nueralgia help in adjucnt to the opiods and muscle relaxants. Also other conservative methods to look into are water therepy, P.T. & O.T., I find that my inversion table helps to relieve pressure but please get clearance before trying anything I've mentioned since every case is different and what helps one person can hurt another. Be honest with your MD's, they aren't mind readers. Keep a pain & symptom log to take to your next visit, include things like extreme onset pain, pain that wakes you in the night, all numbness and tingling, and any loss of bowel or bladder function as that constitutes a medical emergency. Good Luck and keep us posted.
October 31, 2009 - 1:01am
#4
Why not Fentanyl, Phil?
No biggie on this question, Phil, I'm just intrigued as to why you advise against Fentanyl in this particular case. I'm on the 100 mcg patch as well as Fentora for BTP . . . this is for cancer and CP. It works waaaay better than the 360-450 mgs of Oxycodone I used to be Rx'ed. Enjoy the weekend and watch out for the hobgoblins . . . Q
October 31, 2009 - 4:53am
#5
I think his goal was to be an
I think his goal was to be an "intelligent donkey", LOL if you get my filter appropriate word replacement.
October 31, 2009 - 8:34am
#6
Looking back, yes it was rushed.
Upon finding the herniated disk the original Dr. Rx'd me 7.5/750HC x2 a day Neurotin somewhere around 600mg 3-4x day, Cymbalta x1, Volume .5 x2 plus my phych meds. I was also on 40mg x1 of celexa, 100mg x 1 of lamictal and 2mg x2 Xanax. I'm bipolar and the above combo from the phych and the neuro sent me into a Manic episode. Too much " mood stablizer" they said the Lamictal and neurotin we're interfering with one another.
Everything was a little rushed. I couldn't take the pain any longer which led me to the ER which in turn led me to a Neuro that would help me (the previous mentioned one was aganist surgery and would not switch my meds!)
I knew this pain could not go on. When he "opened me up" he had found that my disk had ruptutred, probably why the pain went from a 10 to a 1000 one morning. All I could do was cry 24/7 and I ended up loosing my job but they were nice enough to cover my insurance for an additional month AND pay for it. I ended up having the emergency surgery a week later after loosing my job.
The Dr. after admitting me to the hospital told me he could go in and clean up the disk (a diskoctamy I think) and that if he did that I'd end up having to have another surgery one day or he could "fuse it" and "do it right the first time" That's how a fusion occured. I was on the brink of phycosis, loosing my mind and I just wanted it fixed so I said well, FUSE it!
So really when I made the choice to have surgery I was hooked up to Morphine, all by myself, not really the most mentally healthy of all time and I made a major decision. Boo, wrong decision.
I need to suggest percocet or something along those lines to my Dr. but he told me once before "Vicodin 750 is the strongest thing I perscribe" Alrighty then, looks like I simlpy need to find a new Dr. I just don't want to be looked at a a "drug seeker" and some people treat you that way. Thank you for your relpy.
Also, thank you to everyone else that replied. Good luck to all. This is a great site!!!
Nicole
October 31, 2009 - 1:02pm
#7
surgery
my neuro told me that if i could take the pain to put off surgery as to which he wasnt going to guarantee a pleasant outcome. so until i can get like a 80percentile answer that surgery will help whith my disk problems im on meds to just mask the pain which sucks. i am getting another mri due too numbness tingling pain and no feeling in my right thigh. the last couple months have been my worst in the last 8 yrs of dealing with this. my pcp rxs me ms contin 100mg. t.i.d. and lorcet 10/650 t.i.d. , also along with xanax tid and soma tid and ambien one before bed. i hear lyrica does work well, my mother is on lyrica but due to the cost she can no longer afford it. she just had vertibrae in her back cemented, she has the brittle bone thing going on dont know exactly what she calls it but they only give her 90 norco 7.5/325 a month with the lyrica. it really angers me , she has no insurance and she is about to just let me take her to my pcp where i know she will get a good er med along with break thru. there is no way she can afford another surgery or that will just take every last penny of her retirement really sad. she just got denied her first try for s.s. told her about this site as to which maybe some of our users could help her in the s.s. department. wish i could just afford her a good lawyer to get her approved but im in the same boat as most but i do work 40hr a week and do have insurance at a cost of 160.00 a week for me wife aND MY 2 AND 4 YR OLD. guess i should feel lucky, thats what everyone says. i also put my back surgery on the back burner no pun intended due to my disability is 400.00 max a week and thats not gonna get the rent paid and feed the family, without me working thru my pain. some will say i just want to stay on the meds but i really hate to have to rely and always worry about medication. running out and i have become dependant of them. i say dependant not addicted because that is what it is, i am under a physicians care not like im running the streets for them. sorry for long post.
November 2, 2009 - 9:01pm
#8
FunGov.....try a Myleogram
I am in a similar situation as you are.....L5/S1 fusion in Sept 2008 and here we are Nov 2009 and I am still dealing with a 6-8 pain level daily. They told me the fusion was going great according to standard imaging practices.
They did not know where the source of my pain was, so they scheduled the myleogram which would supposedly give more detail to the fusion area and see if there are any fragments. Well, if you do get the myleogram, DO NOT GET UPRIGHT until they tell you you are completely OK to sit up or walk. I found that out the hard way and had to get a blood patch as the dye leaked out of my spine column into the back of my head.
So the myleogram didnt show much other than a slight annular tear on L4. I am at the point of getting the two titanium rods and screws taken out as I think they are just tearing up my soft tissue and nerves back there. I cannot sit for more than 20 minutes and cannot lay on my back as the pressure on the hardware creates a pain level of 8-9. I am curious to hear about your sources of pain and what you think might be the cause.
Sorry for the long post, but maybe the myleogram will show more detail in your affected area and give them a direction to proceed. I truly wish you luck man as I can completely relate to everyone on here and want a better way of life for all of us.
Vince
November 3, 2009 - 10:41pm
#9
I fear the source of pain is
Vince,
I do fear that the subject of my pain is left behind fragments due to the shooting and mostly sharp pain that shoots down my legs. I was unaware that the hardware could tear up soft tissue and nerves. I do feel as though I am having nerve related issues and this makes sense. I would love the Doc to order up a Mylegram but without insurance i just have to manage it with pharmacuticals for the time being.
I do thank you for the information. I will mention this to my Dr. next time I see him. I do hope that your hardware removal goes well. As bad as the whole surgery process was I would love to live without my hardware, It's like I can feel it all the time.
Kepp us posted on the upcoming surgery & take care.
Nicole
November 3, 2009 - 10:55pm
#10
omg
amazing dr remark about the fragments..! did you call your state medical board or check out this guy's record? there's an increasing tendency in medical profession to push the bottom ($) line & many surgeons always want to cut rather than try pain mgmt, spinal or facet joint injections, the spinal stretching "Rack" therapy machine, etc. you were supposed to be thoroughly BRIEFED before your surgery about possible unpleasant outcomes, etc. i wish you the best & i hope you check with a legal referral service too. on the upside, a friend of mine (letter carrier) had the rod in her spine removed & other treatment done & is back to carrying mail. not as fast and no overtime, but she gets it done & is making a living. hope you have family & friends to support you as you go through all this.
November 5, 2009 - 8:06am
#11
Fungovernor, Nicole, are you
Fungovernor, Nicole, are you still taking the cymbalta? I take it twice a day (the pain/fibro dosage) and it helps with my perception of pain as well as depression. I don't know about your specific mood stabilizer but I take abilify and lyrica without a problem. Maybe that combo would work better for you. I say that because lyrica helps so much with my nerve pain. I've had 3 disks in my neck fused and still have ALOT of arm pain. I'm 34 now and had surgery at 26 and 31, FYI. I would also definitely ask about an extended release pain med. Hopefully your dr is aware that you don't have ins now, and can offer you one that's less expensive (ex release morphine? Is that in generic? I can't remember the name). I know I just suggested lyrica and cymbalta, which aren't available in generic yet, but maybe you can save somewhere!
Take care & good luck. Keep us posted!
MissP
Unless you're rolling in dough you can rule out a CAT or even an MRI scan. That's unfortunate that you're in so much pain. From what I hear, you're being undermedicated after having a (possibly failed) spinal fusion. I've known people with chronic back pain of unknown etiology who get upwards of 200mg of oxycodone per day. What a backwards situation.
I'd find a pain managment clinic who is liberal in their prescribing practices, and just deal with the issue pharmacologically until you can get the studies done.