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Old 02-27-2007, 02:26 PM   #1
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Justoneofus: Specialist followup?

Hey, Tammy: Just checking up on you. I saw that you were going to have some MRIs and see a Johns Hopkins specialist. Did you find out what's causing your troubles yet? Is your fusion okay?

Here's my update: I went to see my surgeon and he said my fusion looked solid, but something may be going on at the disc above (that domino theory). He saw facet arthrosis (fancy name for arthritis I think!) and said that from what he could see on an X-ray the disc looked like it was at the wrong "angle". Harumph. Now I have to go back to PT, get an MRI, and lose the 15 pounds I gained since my surgery (shame on me!). My last fusion (a cervical one) resulted in a herniation in the disc above it, so he said he wouldn't be surprised if it happened with my back too. He did say that the artificial disc could be an option for me if I ever needed another lumbar surgery and would make it less likely to have future herniations. I told him I am not even 12-months post-fusion and that I do not want another herniation as my anniversary gift!

I hope things are better for you, and I am eager to hear how you are doing. After going through such a long recovery period, I can imagine you must be as frustrated and disappointed as I am that the pain has returned. I noticed that the pain brings out the nasty in me. I almost barked at someone today at work and thankfully realized it was just my pain talking. Better buy a muzzle for it!

Schragie
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Old 02-27-2007, 10:56 PM   #2
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Re: Justoneofus: Specialist followup?

Hey Gal! I didnt pay attention to the date of your posting, but I was gonna say great timing! I just saw the surgeon today.

I brought all my lovely photoshoots over the years in my impressive gold portfolio for him to see! The CT was my brightest and shining moment if I do say so myself! hahaha!.. He asked me tons of questions, gave me the usual once over, told me NOT to tell him what my other surgeon's thoughts were. He wanted to draw his own opinion. I totally respected that.

He said that he believes the left side numbness that I woke up with post surgery, and improved some but still there, is probably permanent at this point (and my other surgeon said the same thing, so no surprise). I have some residual numbness in my calf, ankle-weakness (very minor..no footdrop), and part of my foot remain numb.. and my big toe often feels like I have daggers being shot out of it. This is the least of my issues as I told him.

He then said that my surgeon did an excellent job on the surgery. He said that it takes very skilled hands to do the type of surgery he did on me (mininally invasive fusion) and normally he doesnt comment on a doctor's work, but had to say what a good job that was done. I was glad to hear that, especially since I have post surgery issues and now new issues (was a tad concerned that maybe it wasn't a good surgery afterall).

As to what is possibly causing the nerve pain in the legs and the new sciatica post fusion.. is unknown just yet. He cited some possibles which we all know the possibilities.

He ordered an MRI with contrast of the lumbar spine to see what's going on. IF the MRI doesnt show us enough, he will then order a Myleogram CT Scan next. He said that hopefully it's something we can treat conservatively.

I have an MRI scheduled already for this Sunday! Is that fast or what? BUT, my insurance requires precertification for this and the timing might screw up the schedule and have to resched it. No biggie.

I got what I expected and there were no surprises at all. I liked him. He was a bit typical in his approach.. very direct, non aggressive but sort of fast in asking questions and did not want you to digress in anyway.. he wanted step by step his way. Which was fine. With this guy's credentials.. he could easily have been one of those really arrogant types but was not. A good thing for me! And he seems genuine in wanting to help me and not once did he treat me like a "newbie".

The pain alters things doesnt it. I am a weirdo though.. I never get angry, rather I get very quiet when I don't feel well. My smile is less and will disappear if Im in a lot of pain, then it shows in my eyes. Other than that, you would not know anything is different. If I can find a muzzle.. you want me to send to you? ruff ruff! lol. No, I feel for you. This is so hard on us.

I liked the crack about your anniversary gift NOT being a herniated disc. hehe. I agree. I am psyching myself up to be prepared to hear bad news when the MRI comes back. So if another one is going.. I gotta remind myself.. that it might not get as bad as the one they had to fuse and all will be well again. PSYCH!!!! lol.

The disc looks crooked??? egads.. what does that mean exactly, did it fuse oddly? Hopefully the new MRI will prove it to be properly aligned.

Hey at least you only gained 15 pounds. I am ashamed to say I have gained a whopping 35-40 pounds since I injured myself 3.5 years ago . (That's a 4 year old kid Im lugging around! hahaha ) Before, I weighed about 105 and was so fit. I miss being able to work out, but with this new stuff.. I dont get very far . Hopefully things will be identified and they can stick me a few times and I can return to my PT once again.

Yes I am somewhat dissappointed that I am not where I wanted to be in my recovery but I am also not surprised to have new issues. Like you said.. might be the domino effect or my facets as well.

I love the idea of ADR always have. That's how I found my surgeon due to the fact he did ADRs. Course insurance wouldnt pay for it.. and why I ended with the fusion.

I am still on my regular meds and only took the one tab of cymbalta then took no more. IF i have to take a nerve med, I will hold off as long as I can, or at least until my schooling is done. Otherwise.. I may not be able to complete my studies, while my body tries to adjust to the meds. And I was in school when I hurt my back, and I ended up not finishing my class because my brain was in a fog. Can't afford to have this recurrence. The schooling is for a new business and total career change. So this is a big deal for me to be able to complete my studies and do well.

Well I better get to bed, work in the morning. Thanks for asking about me gal, and let's keep each other informed on what's going.

Night fusion twin! (for those that dont know.. we had our fusions done the same day.)

Let me know when your MRI's scheduled.
__________________
"believe in the beauty of your dreams"- E. Roosevelt

L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
Solidly Fused Nov-2006
A Success, but still improving!

Last edited by Justoneofus; 02-27-2007 at 11:04 PM.

 
Old 02-28-2007, 04:34 AM   #3
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Re: Justoneofus: Specialist followup?

Justoneofus - I am glad that you were happy with your new opinion that always helps. Please know that you are in my thoughts and I pray that you are not having the dominio effect.

I just want to make sure I understand your history. You had your fusion one year earlier?

I had a fusion 23 years earlier without hardware and had the one above it fused with hardware just a little over 3 weeks ago. My doctor has warned me that it is common to have this dominio effect and one year is such a short time to have possibly an issue in my opinion. I am hoping I will have at least another 20 years between any problems.

Please keep us posted as I am very interested in your case.

Take care and God Bless.

 
Old 02-28-2007, 02:54 PM   #4
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Re: Justoneofus: Specialist followup?

[COLOR="Navy"]Tammy,

Can I ask where you went for this doctor?

It was good to see that you were at least satisfied with this doctor. It is always good to have that feeling about your doc. Here's hoping he can figure out where the pain is coming from...

Jill[/COLOR]

 
Old 02-28-2007, 09:30 PM   #5
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Re: Justoneofus: Specialist followup?

Pepper - Yes, I can't say I was happy with what the new guy said, but I at least was not surprised by what he said and his first course of treatment was exactly what I hoping/expecting, which is a new MRI. My last MRI was 2 years ago.

I am fused at l4/l5. I have a bulging disc at l5/s1 that has been present since at least age 18. When they did the discogram it caused no pain, but maybe due to the extra work it must do, it's not longer playing nicely. The MRI will hopefully tell us what we need to know. If not, he will then order a Myleogram. He did say that the numbness I have that I woke up with post surgery.. is permanent. I can deal with that, as I do have function.. with very minute weakness. This is the least of my issues.

My fusion was only done 10 months ago and I began to have new symptoms at 6 months. It began so severly that both my PT and doc thought the fusion had failed. CT scan shows solid fusion.

I will indeed keep everyone informed, as I believe that we learn best from each other. Thanks for caring.

Hope you are doing better as the days go on and that you have a solid fusion with no residual issues like some of us are experiencing.
__________________
"believe in the beauty of your dreams"- E. Roosevelt

L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
Solidly Fused Nov-2006
A Success, but still improving!

Last edited by Justoneofus; 02-28-2007 at 09:59 PM.

 
Old 02-28-2007, 09:55 PM   #6
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Re: Justoneofus: Specialist followup?

HI Jill. This new doc I am seeing is from John Hopkins, and his name is Ali Moshirfar. Mega credentials. BUT, he has joined on with another group out in Ashburn (part-time). He is listed. This group is a complete ortho and spine center with pain management, and PT on site.

Aren't you seeing a surgeon with the VA spine institute? (Excellent group and one of the best reputations in this entire area.) I was with Dr. Haas for awhile until he stopped taking my insurance. Had Dr. Haas done my surgery, he would have done a double fusion L4-S1.

I live out near Stephens City, so since I had to go out of network anyway to get a good surgeon (at the time), I chose a spine doc closer to home.. and turns out I just got very lucky to have done some homework and got a great surgeon. The ONLY reason I have made a change, was because Dr. Moshirfar is an in-network surgeon and has the vast experience. If I am looking at more surgery.. it would be nice to take FULL advantage of the in-network bennys. BUT.. if I dont like this guy.. the doc out here says he would take me back in a heartbeat. (When he saw me last week he says.. "so I hear you want a divorce!" I said.. "well no, just a separation". -- he can be quite funny at times.. and he knows I work for a law firm. hahaha).

I will let you know how things go with this guy. (Hey, If I dont like him.. I will run. Okay.. I will hobble out of there doing the Tim Conway shuffle and head right back to my former surgeon. lol. Just "KNOWING" I have that "safeguard".. gives me such peace of mind beyond words). But I think I will like this guy moving forward. He is not arrogant at all. In fact, he asked if I would like for him to send his findings to my former surgeon. That was a fabulous jesture on his part. I said.. YES Please with a big smile.

So first thing is to get that MRI done (which will be done at reston hospital) and see where we go from there. As much as I don't want to have pain induced.. I wouldnt have mind a Mylegram done just to see what/where/how much nerve damage there really is. I'm one of those that just has to "know" crap. Seems to help me in some way. My son is the same way.. poor guy! hehehe.

How are you doing?

All the best to you. Tammy

I
__________________
"believe in the beauty of your dreams"- E. Roosevelt

L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
Solidly Fused Nov-2006
A Success, but still improving!

Last edited by Justoneofus; 02-28-2007 at 09:57 PM.

 
Old 03-01-2007, 09:27 AM   #7
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Re: Justoneofus: Specialist followup?

[COLOR="Navy"]Tammy,

Thanks for responding. Yes, I'm at the Virginia Spine Institute. With the head cheese himself, Dr. Schuler. He is a gifted surgeon who has little to no bedside manner. He has gotten better with me because I didn't sue his sorry little tush. I'm sure that my chart has a large red flag on it to "HANDLE WITH CARE".

If I need surgery again, it would be with Dr. Subach. He was with Shuler when they did the second surgery and put the 15" rods in. It was at 5 pm and lasted another 5.5. hours. Subach was also the one who admitted me when I had my blood clot. What a great soul!

I am also using the pain manangement dr. Dr. Ngyuen (Winn). He is close to sainthood in my book. The Yang of the Yin and Yang there. He is a great pm dr. He is truely concerned with how I am doing and how we can regulate the problems. When I saw him last month and I told him the pain i was in, his first comment was, "I want to get you out of pain now. That is my first concern." This cemented me going to him.

I too, lost them on insurance coverage. They dropped BlueCross/Blue Shield Care First. They told me it was because they were so late in paying their bills. I talked to our benefits guy who is above great. He explained it to me and from what he said it sure sounds like they made a mistake in dropping Care First. Oh well. I have back-up coverage through Tri-Care BUT..... The only reason I continue to see them is that I am not completed "cured" so to speak, from the surgery and I know I would have trouble getting someone else to see me at this point...

Weather is going to change today, can feel it in my bones. Just another day in Paradise, living with better chemistry! I prefer the days of no change, but my back doesn't always play nice. I do believe that it has a mind of it's own and is going to take over my body some night!

hugs........
Jill[/COLOR]

 
Old 03-01-2007, 02:32 PM   #8
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Re: Justoneofus: Specialist followup?

Hi Tammy! Sorry to hear you have permanent numbness. I have some numb spots from my neck fusion, so I am familiar with the feeling (or lack of it!).

My MRI is on Monday, but they are not doing it with contrast (doc says not necessary for me).

I am so pleased to hear that you liked your new doc and he was what you expected. I guess we're both back in diagnostic test mode, and I hope you get enough information from your MRI such that you do not require a myelogram. Also, it must be great to have your first surgeon's work validating by another doctor. My surgeon was happy with his own work, looking at my X-ray, telling me it could be in a textbook. I said, "Yes, and doesn't my *** look great in it?"

Congrats to you on being back in school and I hope that the pain isn't too much of a distraction for you.

As for facets and dominos, who the heck knows? I guess I am more surprised than you to have new issues, but on some level I know this back stuff is going to be a lifelong novel-- hopefully with very short chapters! Still, I am FED UP. I relegated my big jelly icepack to a fridge I have in my shed, and somehow bringing it back into the house feels like a big step backward!

My weight gain is not the size of a 4-year old, but it's exactly the weight of my childhood dog -- a Cairn Terrier. Now I am calling my fat "Kelly" after her. I hope that with some better food choices and more walking/exercise it will come off.

I am not sure what to say about the disc being crooked. It's the disc above my fusion and he said something about the alignment of it compared to the others -- it's parallel when it should be at a slight angle. We'll see what the MRI shows, because you can't tell too much on an X-ray.

Last time I had an MRI I fell asleep in the machine, so hopefully I'll have a nice nap for this one too!

Feel better all and keep the posts coming!

Schragie
__________________
4/2006:TLIF L5/S1
2002: C4-5 herniation
1/1999: ACDF C5-C7

 
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