Shoreline
04-08-2004, 05:53 PM
Hey Guys, I said I would update so, Here is the deal. I went in at 9am and waited about 20 minutes and they took me back, set an IV line, gave some valium and moved me into the procedure/fluoroscopy room. This time they were doing a single bolus injection of morphine. My last trial was inpatient with a cath placed into the intrathecal space "sac that surrounds the spinal cord" that easily allows meds to migrate into the cord and up and down the back.
Anyway, the inpatient trial caused a spinal fluid leak from the get go so every time I stood up I barfed, It was kinda hard to call that a success although I spent 3 days in patient titrating the dose up and did notice some relief.
Anyway, this time they used a 25 gage needle instead of an 18 gage cath, so fortunately no leaks. I actually had the best 4 hours I can remember in years. They kept me for observation and fed me and let me go after about 41/2 hours after the injection. They went in at L4 and it relieved about 75% of my pain at the base of the fusion and 25% at the top. With intrathecal infusion the meds would be more prone to migrate once saturated and take care of the top of the fusion too. So the trial was basically a great success.
I hadn't had that much relief in ...I can't remember when. After I got home, I took my regular meds as instructed and as the IT morphine wore off it was like that same 100 pound bag started resting on my shoulders again, all the energy drained and I realized just how much being in pain sucks out of you. The relief from meds can be amazing.
Ken ask about some background on what happened so sorry if I'm repeating. I had a laminectomy/discectomy on L3-4 and 4-5 in 93, it relieved the leg pain but left some back pain, I returned to work after 10 weeks and reinjured myself 6 months later, At this point it was comp. I went through comp pt, comp surgeons that said I was fine, comp work hardening, comp cutting me off to force a settlement and eventually got an IME from Duke " Independent medical eval". They wrote all over my MRIs and other films and the stuff they pointed out was hard to deny
So comp allowed me to have a fusion to stabilize my spine with one of their docs, Of course I was cut off from meds early after surgery, any request for pain relief was met with addiction crud and some ended up in my GP file, I think at some point every CP patient gets called an addict.
After more rehab and work hardening, I was supposed to return to work,but I couldn't and they cut off payment again, I decided to settle just to get out of the BS comp puts you through.
Took a lump some, 2 years of continued medical and agreed not to return to my old employer. Fine... I took a year off, got in shape, and went to work in a little less strenuous job, so I thought. Less strenuous became 12-15 hours 6 days a week on my feet in a huge Furniture show room.
The first set of hardware snapped almost exactly 2 years after the settlement so comp was no longer responsable medical wise. I had a great beni package so I figured, fix the broken stuff and redo the fusion and I would be back to work.
It didn't quite work out that way. The fusion had crushed the disc above and below, when they tried to put a screw in, it split a vertebrae which meant they had to go higher and wrap the broken vertebrae with wire. One of the broken screws would not back out so I still have some of the old stuff in me and because that screw didn't back out they had to go an extra vertebrae downward to get two good screws in. My 4 hour surgery turned into a 12 hour marathon fusion of my entire lumbar spine, L1-S1.
More PT more pain management without opiates, all the non opiate methods imaginable were tried and learned. You take what's useful and toss the rest but I never refused any attempt to reduce my pain.
Anyway, so more PT then more PM and after still being bed wridden my SSD attorney recommended a neuro/psych that practiced PM, just happened to be in network and had been availabvle for the last 25 years had anyone had the decency to refer me to him. That's another story. He's been taking good care of me but last summer I broke a new screw, broke another a few months ago, this fusion has failed too and I can either keep taking meds that make me feel crappy much of the time or go the pump route.
My doc doesn't see the pump as a cure all, He understands it's just another tool. I have consulted with other surgeons about the possibility of being fixed, that isn't going to happen so managing pain is about all I have.
I did win my SSD case after 2 years but the pay cut was tremendous from working to SSD. No script insurance has me using meds I can afford, not that work the best. My wife's present employers Med insurance is priced out of reach so the pump is a viable alternative that would be covered by Medicare.
Anyway, I do need to lay down, I still have lots of indecision for a few reasons I'm sure I'll post about later.
Dave "shore"
PS, Thanks mods for cleaning up my problem of multiple postng yesterday, My computer kept feezing and I was a bit impatient, I guess that's how I blew it so badly. Thanks Shore
Anyway, the inpatient trial caused a spinal fluid leak from the get go so every time I stood up I barfed, It was kinda hard to call that a success although I spent 3 days in patient titrating the dose up and did notice some relief.
Anyway, this time they used a 25 gage needle instead of an 18 gage cath, so fortunately no leaks. I actually had the best 4 hours I can remember in years. They kept me for observation and fed me and let me go after about 41/2 hours after the injection. They went in at L4 and it relieved about 75% of my pain at the base of the fusion and 25% at the top. With intrathecal infusion the meds would be more prone to migrate once saturated and take care of the top of the fusion too. So the trial was basically a great success.
I hadn't had that much relief in ...I can't remember when. After I got home, I took my regular meds as instructed and as the IT morphine wore off it was like that same 100 pound bag started resting on my shoulders again, all the energy drained and I realized just how much being in pain sucks out of you. The relief from meds can be amazing.
Ken ask about some background on what happened so sorry if I'm repeating. I had a laminectomy/discectomy on L3-4 and 4-5 in 93, it relieved the leg pain but left some back pain, I returned to work after 10 weeks and reinjured myself 6 months later, At this point it was comp. I went through comp pt, comp surgeons that said I was fine, comp work hardening, comp cutting me off to force a settlement and eventually got an IME from Duke " Independent medical eval". They wrote all over my MRIs and other films and the stuff they pointed out was hard to deny
So comp allowed me to have a fusion to stabilize my spine with one of their docs, Of course I was cut off from meds early after surgery, any request for pain relief was met with addiction crud and some ended up in my GP file, I think at some point every CP patient gets called an addict.
After more rehab and work hardening, I was supposed to return to work,but I couldn't and they cut off payment again, I decided to settle just to get out of the BS comp puts you through.
Took a lump some, 2 years of continued medical and agreed not to return to my old employer. Fine... I took a year off, got in shape, and went to work in a little less strenuous job, so I thought. Less strenuous became 12-15 hours 6 days a week on my feet in a huge Furniture show room.
The first set of hardware snapped almost exactly 2 years after the settlement so comp was no longer responsable medical wise. I had a great beni package so I figured, fix the broken stuff and redo the fusion and I would be back to work.
It didn't quite work out that way. The fusion had crushed the disc above and below, when they tried to put a screw in, it split a vertebrae which meant they had to go higher and wrap the broken vertebrae with wire. One of the broken screws would not back out so I still have some of the old stuff in me and because that screw didn't back out they had to go an extra vertebrae downward to get two good screws in. My 4 hour surgery turned into a 12 hour marathon fusion of my entire lumbar spine, L1-S1.
More PT more pain management without opiates, all the non opiate methods imaginable were tried and learned. You take what's useful and toss the rest but I never refused any attempt to reduce my pain.
Anyway, so more PT then more PM and after still being bed wridden my SSD attorney recommended a neuro/psych that practiced PM, just happened to be in network and had been availabvle for the last 25 years had anyone had the decency to refer me to him. That's another story. He's been taking good care of me but last summer I broke a new screw, broke another a few months ago, this fusion has failed too and I can either keep taking meds that make me feel crappy much of the time or go the pump route.
My doc doesn't see the pump as a cure all, He understands it's just another tool. I have consulted with other surgeons about the possibility of being fixed, that isn't going to happen so managing pain is about all I have.
I did win my SSD case after 2 years but the pay cut was tremendous from working to SSD. No script insurance has me using meds I can afford, not that work the best. My wife's present employers Med insurance is priced out of reach so the pump is a viable alternative that would be covered by Medicare.
Anyway, I do need to lay down, I still have lots of indecision for a few reasons I'm sure I'll post about later.
Dave "shore"
PS, Thanks mods for cleaning up my problem of multiple postng yesterday, My computer kept feezing and I was a bit impatient, I guess that's how I blew it so badly. Thanks Shore