wolfmarket
03-06-2006, 12:41 PM
Any comments?
FINDINGS: Small chronic Schmorl's node endplate deformities are seen at several levels and mild Modic type 1 discogenic endplate change is present at L2-3 and L3-4. Mild spondylosis is present primarily ay L2-3. No fracture is seen. There is no spondylolisthesis. There is mild lumbar scoliosis convext to the left.
The L1-2 disk is partially desiccrated and mildly reduced in height. Small central posterior disk protrusion deforms the thecal sac without narrowing the spinal canal. The neural foramina are patent bilaterally.
The L2-3 disk is partially desiccated and mildly reduced in height. Small left paracentral posterior disk protrusion is again identified, narrowing the left lateral recess. There is additional contralateral small right posterolateral foramina disk protrusion. There is mild to moderate bilateral neural foraminal encroachment. The canal is within normal limits.
The L3-4 disk is desiccated and reduced in height. Mild to moderate paracentral posterolateral disk protrusion is again identified. There is underlying posterior disk bulge, facet hypertrophy, mild spinal stenosis and bilateral neural foramina encroachment, mild right, moderate left.
The L4-5 disk is desiccated and reduced in height. Small central posterior disk protrusion is present. there is facet hypertrophy, mild spinal stenosis and mild bilateral neural foraminal enroachment.
IMPRESSION
1.SMALL CENTRAL POSTERIOR DISK PROTRUSION AT L1-2
2.LEFT PARACENTRAL POSTERIOR DISK PROTRUSION AT L2-3, NARROWING THE LEFT LATERAL RECESS AND NEURAL FORAMEN; CONTRALATERAL RIGHT FORAMINAL DISK PROTRUSION AS WELL.
3.MILD TO MODERATE LEFT PARACENTRAL POSTEROLATERAL DISK PROTRUSION AT L3-4
4.SMALL CENTAL POSTERIOR DISK PROTRUSION AT L4-5
All comments welcome!
Alan
FINDINGS: Small chronic Schmorl's node endplate deformities are seen at several levels and mild Modic type 1 discogenic endplate change is present at L2-3 and L3-4. Mild spondylosis is present primarily ay L2-3. No fracture is seen. There is no spondylolisthesis. There is mild lumbar scoliosis convext to the left.
The L1-2 disk is partially desiccrated and mildly reduced in height. Small central posterior disk protrusion deforms the thecal sac without narrowing the spinal canal. The neural foramina are patent bilaterally.
The L2-3 disk is partially desiccated and mildly reduced in height. Small left paracentral posterior disk protrusion is again identified, narrowing the left lateral recess. There is additional contralateral small right posterolateral foramina disk protrusion. There is mild to moderate bilateral neural foraminal encroachment. The canal is within normal limits.
The L3-4 disk is desiccated and reduced in height. Mild to moderate paracentral posterolateral disk protrusion is again identified. There is underlying posterior disk bulge, facet hypertrophy, mild spinal stenosis and bilateral neural foramina encroachment, mild right, moderate left.
The L4-5 disk is desiccated and reduced in height. Small central posterior disk protrusion is present. there is facet hypertrophy, mild spinal stenosis and mild bilateral neural foraminal enroachment.
IMPRESSION
1.SMALL CENTRAL POSTERIOR DISK PROTRUSION AT L1-2
2.LEFT PARACENTRAL POSTERIOR DISK PROTRUSION AT L2-3, NARROWING THE LEFT LATERAL RECESS AND NEURAL FORAMEN; CONTRALATERAL RIGHT FORAMINAL DISK PROTRUSION AS WELL.
3.MILD TO MODERATE LEFT PARACENTRAL POSTEROLATERAL DISK PROTRUSION AT L3-4
4.SMALL CENTAL POSTERIOR DISK PROTRUSION AT L4-5
All comments welcome!
Alan
Sponsor
mpvt
03-06-2006, 01:12 PM
Do you have any pain radiating down one or both legs????
tina76
03-06-2006, 03:12 PM
Where do you go from here Alan? Now that the new results are back,etc....what are your doctor's thinking? Hopefully they have SOME sort of a good plan for you!
Tina :)
Tina :)
wolfmarket
03-07-2006, 12:42 AM
I have severe weakness in my legs with some pain radiating down them.
I do have severe back pain, and intense sciatica.
As previously posted, I am on the 100 mcg Fentanyl Patch with 30 mg Roxicodone for BT. And even though the Roxis help me and the patches don't, my PM Doc will not Rx OxyContin. I've also tried MS Contin (up to 100mg BID) with little relief.
Alan
I do have severe back pain, and intense sciatica.
As previously posted, I am on the 100 mcg Fentanyl Patch with 30 mg Roxicodone for BT. And even though the Roxis help me and the patches don't, my PM Doc will not Rx OxyContin. I've also tried MS Contin (up to 100mg BID) with little relief.
Alan
mpvt
03-07-2006, 09:10 AM
100mg bid of ms contin is way to low a dose for someone with your pain.Also can you ask your doctor about wearing 2 75mcg patches giving you 150mcg instead of 100mcg.Just because they only make up 100mcg patches doesn't mean you can't go any higher.If you get on the morphine again try and take it TID ms contin only last's about 8 hours.I know it might not seem this way but you seem to be underdosed.Good luck....Dave
Shoreline
03-07-2006, 10:01 AM
Hey Allen, IMO, At best radiologist reorts give a surgeon a guide to lok for things, But unlike GP's and PM docs, They rea;lly don' t have the day n and day out exp[erience reading these reports and then performing surgery and seeing exactlywhta mild bulge loks like.
Personally I've yet to met a surgeon hat even read a Radoiologist report, it's as if they don't want their diagnostics talents tainted by a preformed opinion. If a surgeon ordered a fresh MRI, he will want to see them for himself. If your GP or PM docs ordered it, He may go entirely by a rdiolofgist report that may or may not ndicate teneed for aurgical consult. Basically a non surgeon, that can' fix anything even if they see a gross abnormaloty veiwing your Xfilms gives you noting moe than a non surgical opinion. Even if the see something terrible that neds to be fixed now, you will still have to be evaluated by a surgeon. No surgeon is going to basea need for surgery bu the rport of another doc, so Please take them to a NS that specializes in the spine. I've seen to many GP's and PM ocs order these ests and proclam a diagnosis or lack of need of sugrgery when they simply aren't quaified. Let the surgeon do gis job and get a surgical opinion on the tests and your present condition, his exam is gooing to have as much to do with the decision to opearte as the films. ie. If you showed no grossly abnomal disc bulge in your nck but have lost 50% of your strength in one and and reflexes from the elbow down, that tells him as much as the expensive diagnostic test and everyone elses evalauation of what the saw or what they hink those finding indicate as far as surgery. They aren't surgeons, so they aren't going to be the one fising you and have no pull as far as an actual surgeons decision to operaeor not based on findings and eval.
If your GP or PM oprdered the test and say there is nothing that can be surgicaly fixed, they are way ovcer stepping their bounderies.
You have already spent the big bucks on the test, you may as well as get an actual surgeons opinion on the test even if it ruffles the feahers of the doc that ordered the test and ten formned a diagnosis and or treament plan based n their interpreation of te radiologist interpretation.
Hey allen, I use toxycodone as BT med too, and it works fairly well, better han anything else. But Ihave also used xyC Cand it wasn' anywhere near as effective and I grew rapidly tolerant to whatever dose I took daily. If your doc is unwilling to change or increase emeds, Strarting with a s surgical opinion is a goodway to tip toe out of a practice you fel bound too simply becuase they are making an effort at managing your pain and that's better han no treatment as I would presume you have experienced at some point.
The best way to step outside your contract is for anoither opinion or investigatioin of a modality your present doc doesn't offer.
God lcuk, Dave
Personally I've yet to met a surgeon hat even read a Radoiologist report, it's as if they don't want their diagnostics talents tainted by a preformed opinion. If a surgeon ordered a fresh MRI, he will want to see them for himself. If your GP or PM docs ordered it, He may go entirely by a rdiolofgist report that may or may not ndicate teneed for aurgical consult. Basically a non surgeon, that can' fix anything even if they see a gross abnormaloty veiwing your Xfilms gives you noting moe than a non surgical opinion. Even if the see something terrible that neds to be fixed now, you will still have to be evaluated by a surgeon. No surgeon is going to basea need for surgery bu the rport of another doc, so Please take them to a NS that specializes in the spine. I've seen to many GP's and PM ocs order these ests and proclam a diagnosis or lack of need of sugrgery when they simply aren't quaified. Let the surgeon do gis job and get a surgical opinion on the tests and your present condition, his exam is gooing to have as much to do with the decision to opearte as the films. ie. If you showed no grossly abnomal disc bulge in your nck but have lost 50% of your strength in one and and reflexes from the elbow down, that tells him as much as the expensive diagnostic test and everyone elses evalauation of what the saw or what they hink those finding indicate as far as surgery. They aren't surgeons, so they aren't going to be the one fising you and have no pull as far as an actual surgeons decision to operaeor not based on findings and eval.
If your GP or PM oprdered the test and say there is nothing that can be surgicaly fixed, they are way ovcer stepping their bounderies.
You have already spent the big bucks on the test, you may as well as get an actual surgeons opinion on the test even if it ruffles the feahers of the doc that ordered the test and ten formned a diagnosis and or treament plan based n their interpreation of te radiologist interpretation.
Hey allen, I use toxycodone as BT med too, and it works fairly well, better han anything else. But Ihave also used xyC Cand it wasn' anywhere near as effective and I grew rapidly tolerant to whatever dose I took daily. If your doc is unwilling to change or increase emeds, Strarting with a s surgical opinion is a goodway to tip toe out of a practice you fel bound too simply becuase they are making an effort at managing your pain and that's better han no treatment as I would presume you have experienced at some point.
The best way to step outside your contract is for anoither opinion or investigatioin of a modality your present doc doesn't offer.
God lcuk, Dave
wolfmarket
03-08-2006, 03:22 AM
The surgeon was the one who ordered the test.
Dave, thank you very much for your response. Let me ask you a tough question. Would this MRI support a disability rating from Social Security?
As for my pain, it is getting worse. I am able to drive and get around, but the pain is severe. Especially this wrap around pain that goes around the right hip area. The patch is doing nothing. The Roxis are the only thing that help.
Alan
Dave, thank you very much for your response. Let me ask you a tough question. Would this MRI support a disability rating from Social Security?
As for my pain, it is getting worse. I am able to drive and get around, but the pain is severe. Especially this wrap around pain that goes around the right hip area. The patch is doing nothing. The Roxis are the only thing that help.
Alan
wolfmarket
03-14-2006, 02:17 AM
MPVT, I do feel underdosed when I read about some on this board with apparantly fewer problems than I getting fairly large doses of OxyContin or Actiq. I know everyone is different and hey, I am getting 100 mcg Fentany patch and 30 mg Roxi. But the problem is not so much how much I'm rx'ed as it is WHAT I'm getting rx'ed.
My pain level has skyrocketed lately. The 30 mg Roxis are the only thing that gives me relief. The patch is a waste. I seem to respond well to oxycodone. You would think that logic would suggest then, using OxyContin as my base med. But nope, Doc won't Rx it.
Maybe I do need to raise the patch to 150.
Another thing I cannot understand is the widespread off label use of actiq. I might be exaggerating, but it seems to me that actiq is rx'ed by some docs for those with nothing more than hangnails!
But seriously, I do feel that my current regiment is not cutting it. I am in serious level 8-10 pain now, with severe sciatica, severe hip pain, severe pain in middle of my back, severe pain in lower back. And now my left hand hurts so much. It feels like it is asleep but yet, it is filled with stiffness and pain.
Thanks for your comments and I hope that my PM Doc will see things the way you do!
Alan
My pain level has skyrocketed lately. The 30 mg Roxis are the only thing that gives me relief. The patch is a waste. I seem to respond well to oxycodone. You would think that logic would suggest then, using OxyContin as my base med. But nope, Doc won't Rx it.
Maybe I do need to raise the patch to 150.
Another thing I cannot understand is the widespread off label use of actiq. I might be exaggerating, but it seems to me that actiq is rx'ed by some docs for those with nothing more than hangnails!
But seriously, I do feel that my current regiment is not cutting it. I am in serious level 8-10 pain now, with severe sciatica, severe hip pain, severe pain in middle of my back, severe pain in lower back. And now my left hand hurts so much. It feels like it is asleep but yet, it is filled with stiffness and pain.
Thanks for your comments and I hope that my PM Doc will see things the way you do!
Alan
mpvt
03-14-2006, 01:54 PM
Good luck and let us know how you make out with the pm doc.....Dave