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Old 09-24-2002, 06:25 PM   #1
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Join Date: Sep 2002
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MaryLou HB User
Need Advice

Hi Everyone!

I have been reading some of the recent postings, and I do not believe my pain is so bad after reading what all of you are going through. However, I am looking for advice about what I can do so I don't get worse.

Last November, while in physical therapy for bursitis of the left hip, I started to have pain running down my left leg at night, keeping me awake. I thought it was related to the physical therapy, so I didn't go to the doctor for several months. He sent me to an orthopedic specialist who ordered an MRI and bone scan. The bone scan was negative, but the MRI showed two degenerating disks, L-4 and L-5. Also, L-5 is bulging and torn, which apparently touches a nerve and causes the pain down my leg. I took Bextra for pain in June and July. I had 10 physical therapy sessions which ended in early August and included heat therapy, massage and traction. I also was assigned stretching exercises which I am still doing. I felt better for awhile and stopped taking the Bextra. After about a week, the pain started coming again at night. It became more of a sharp pain in my hip that proceeded down my leg. In September, I saw the doctor again who said I should start up the Bextra again. She also recommended a discogram, and then possibly a neuroplasty. There is also the possibility of cortizone injections in my facets (?)

After reading about the horrors of discograms, I have decided not to go through with it. Frankly, it does not sound like it will get me anywhere, and that it might make things worse.

I would like to know what other options are out there that I can discuss with the doctor later this week. Has anyone had accupuncture for this type of pain? Should I try to get more physical therapy? Can I continue on pain medication indefinitely? I want to avoid all these painful procedures that sound like they just lead to more pain.

Any helpful advice would be greatly appreciated. <IMG SRC="http://www.healthboards.com/ubb/heart.gif">

 
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Old 09-24-2002, 06:55 PM   #2
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Join Date: Sep 2002
Location: Brewster, MA
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aiguier HB User
Re: Need Advice

Hi, There are alot of different methods out there. Definitely check them out with references from people who have had them. My husband had 3 surgies on one disc L-4. The final step was a back fusion with a titanium screw and bone graft, which worked. He now has the above disc with the same problem and he has been seeking alternative ways. He tried accupuncture which did not work. How could it if the hernia is pressing the nerve and the accuncturist doesn't deal with the disc. We know people who had other types of methods with no success. Definitely ask questions on future problems down the road for any mechincal devices and if major or minor surgery. (example: Screws that come undone could require surgery to put them back or replaced.)
Good luck.

 
Old 09-24-2002, 06:59 PM   #3
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Join Date: Sep 2002
Location: Monterey Peninsula, CA
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EventHorizon HB User
Re: Need Advice

Hi MaryLou,

Bextra, like Celebrex and Vioxx is a good COX-2 selective inhibitor - works like aspirin or Aleve, but lasts longer and doesn't upset the stomach.

Before you get the cortisone injections, see if you can try an oral steroid, to see if inflammation is your problem. I tried a week of prednisone, IM cortisone shots, etc. My grandmother had cortisone injected into her spine, and warned me against doing that. I won't even let them inject my hip.

Before you EVER consider nucleoplasty, ask people who have already had it. Ask your doc for a list of patients who have had the procedure, and call and ask them if it helped.

Pharmacologically, check out a drug called 'Ultram' It affects opiate receptors, but has not been found to be addictive by the FDA. It also affects seratonin and norepinephrine levels, causing CNS stimulation, like when you drink coffee, acting like a short-term antidepressant (1-2 days).

It is opiate cross-tolerant, so if you do think about taking it regularly, remember that meds like codine or vicodin won't help much while you are on it. It's the ONLY drug of its kind, and I'd recommend trying it before anything invasive that you may later regret.

Peace and Happiness be with you,

-EventHorizon


<p>[This message has been edited by EventHorizon (edited 09-24-2002).]

 
Old 09-24-2002, 08:56 PM   #4
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Join Date: Sep 2002
Location: Salt lake City-only until hubby retires
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Jamy9840 HB User
Re: Need Advice

Hi Mary Lou--My name is Jamy Lou. I had a disk-o-gram and it wasn't too big of a deal. For mine, they had a blood pressure thingy on my finger, oxegen, and an IV. It was a sterile environment like and operating room. Anyway, somehow they "reproduce" your pain to see which disk is causing the problem. I can't answer your questions, but I just wanted you to know that the disk-o-gram WAS NOT a fun test, but it wasn't a horror or fun. Good luck when you see your Dr!!
Jamy LOU

 
Old 09-24-2002, 09:27 PM   #5
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Join Date: Jan 2002
Location: Northrop, Mn.
Posts: 490
Kamden HB User
Re: Need Advice

I found physical therapy to be the most beneficial when I had a herniated disk, and taking Vioxx for the inflamation. PT did not cure me, but it did more for my pain than any other treatment. I still ended up having to have surgery a year later, but I don't regret it. About not injuring yourself further, that is the hard part. All of our upper body weight is carried in this area of the back, and sitting, standing, and bending can all aggravate it, untill it heals. I don't know what to tell you here except to tread lightly! I have had back problems for more than 20 years, and am very carefull now with lifting, standing too long, too much bending, so I don't re-injure myself also, it seems to be a balancing act for me. I wish you luck and hope you find some relief from your pain.

 
Old 09-25-2002, 04:54 AM   #6
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Join Date: Dec 2000
Location: New York, USA
Posts: 1,709
BAXTER HB User
Re: Need Advice

Hi Mary Lou,

Sorry to hear about your pain. I hate to be short, but I am on way way out the door for work.
I have a long history, but one thing I can say is I think the discogram is by far the best and most accurate test to rule out other conditions.
Mine was on 9/13/02 followed by a cat scan the same day.
MRI's & Cat Scans alone, don't show the whole picture.
Yes, it was hell going through the procedure, it depends how many discs they are testing, the more tested, the more pain.
I had four levels done.
I am awaiting an appointment to a new doctor to discuss fusion surgery (I might have too many levels) so yes, I will also try nucleoplasty, as I am a candidate for that.
I already had a failed radio-frequency ablation procedure (What a waste that was ! )

If I had the discogram done two years ago, I would not have had to go through 13-14 various blocks.
The doctor thought my problem was with the facet joints, but he was wrong.

I am leaking fluid from two discs, when I move or sit, it is bone on bone according to my doctor.
I only hope that I don't have too long of a wait to get into the new doctor.
Also have a buldge on one disc, and a herniation on another.

I highly recommend the discogram, although the non-stop headache I've had since then, seems to be my only side effect.
It feels as though someone has a vice on my head.

I hope I have helped you somewhat, again, this is only my opinion. Others might feel differently.

I'm glad I had the discogram.

Take Care,
Baxter

 
Old 09-25-2002, 05:08 AM   #7
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Join Date: Nov 2001
Location: North Augusta, Ontario, Canada
Posts: 22
rosiedun HB User
Re: Need Advice

Mary Lou

If your herniated disc is pressing on the nerve that runs down your leg get to the doctor girl. If that nerve doesn't receive the circulation it needs it will die....and once a nerve dies it never comes back.

It happened to me. My left leg is now numb and I have foot drop because the doctors disn't believe there was anything wrong with me. I was bluntly told my left left numbness and inability to walk was "in my head". My kidneys shut down three days later.....that go me some attention. Chronic pain, a foot brace and a cane....not exactly how I had invisioned my life.

Don't let them put you off. Get some attention.

Please leg us know how you are donig. I wish you the best.

Rosie

 
Old 09-25-2002, 06:54 PM   #8
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Join Date: Sep 2002
Location: Maryland
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MaryLou HB User
Re: Need Advice

Thanks to all of you who have responded. The information is very helpful. I am preparing a list of questions for my doctor and your answers have helped me realize how very complicated this is. I will let you know what ends up happening. In spite of the favorable comments, the thought of the discogram terrifies me. A friend just had a mylogram and also had severe headaches following the procedure. How long do they go on?

 
Old 09-25-2002, 07:39 PM   #9
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EmtShirl HB User
Re: Need Advice

MaryLou~

No, a discogram is not a walk in the park but it is not the worst test there is.....

I have to agree with all of what Jamy other then that with mine I didn't need Oxygen. They do give you something to sedate you but it doesn't put you out. You need to tell the doctor what you are feeling while he is doing the test.

Just to let you know my Neuro would not do fusion surgery with out the discogram. This test is very accurate and will determine which disc's are giving you problems.

I hope you decide to do what is best for you. Good luck!

Shirl <IMG SRC="http://www.healthboards.com/ubb/heart.gif">

 
Old 09-26-2002, 05:01 AM   #10
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Location: New York, USA
Posts: 1,709
BAXTER HB User
Re: Need Advice

Hi Mary Lou,

The headache is finally getting better as of this morning.
Not all people get them.
I didn't have oxygen either.
Shirl is correct in stating it's not the worst thing to go through, it's just not the easiest thing, but very accurate.

You are very smart arming yourself with a list of questions for the doctor, that is what they are there for.
I wish I came across these boards two years ago, it would have saved me alot of wasted procedures.
It is such a helpful site.

Good luck, and keep us informed.

Baxter

 
Old 09-26-2002, 04:37 PM   #11
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Location: Maryland
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MaryLou HB User
Re: Need Advice

Baxter -

I'm glad to hear your headache is better. It lasted about two weeks? Was it constant? Were you able to go to work? Did any medicines help? I think I am prone to headaches, so if I do decide to have the discogram, I want to be prepared.

MaryLou

 
Old 09-26-2002, 06:03 PM   #12
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Join Date: Dec 2000
Location: New York, USA
Posts: 1,709
BAXTER HB User
Re: Need Advice

Hi Mary Lou,

Yhe headache was constant, all day A.M. to P.M.
I was about ready to return to the doctor, but it got better all of a sudden. Now it just comes and goes.
They told me to drink alot of clear caffeinated sodas.
I was slamming down the Mountain Dew for sure, it must have worked somewhat.
I usually only prefer decaf though.
I couldn't miss work, I was too busy, so I had to just deal with it.
I didn't take any extra meds, except Aleve, because I am already taking my Vicodin.
If I had called and inquired a little earlier, I'm sure it would not have taken so long, or been so intense.

I wish you well if you decide you need the discogram, but please remember, not everybody gets the headache.
I hope you don't.
I think I got them, because I had four levels done.

Have a great evening.
If I can help further, just drop me a line.

Take Care,
Baxter

 
Old 09-26-2002, 11:58 PM   #13
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Join Date: Aug 2001
Location: Newburg, Maryland, USA
Posts: 74
OLIVER-DOVE HB User
Re: Need Advice

Hey Marylou,

Let a fellow Marylander give some advice. The bulging disk is of concern. Sometimes physical therapy can help reduce the size so there is no problem. What really concerns me is the torn disk. It could be the reason for the problem. The best solution for that is a lapriscopomy. I know the spelling is wrong. What they do is go in with a scope and trim the ofending disk piece or have heard some say they possibly reattach the piece back to the disk. This is the least invasive procedure and has had some great results. In short order you find out if everything will work. Should it not work then you have diskectomy with fusion was the best route to go. Before being layed up for 6 months to a year I would try the less invasive procedure first.

Keep in touch,

Oliver <IMG SRC="http://www.healthboards.com/ubb/wave.gif">

 
Old 09-29-2002, 03:15 PM   #14
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Join Date: Sep 2002
Location: Maryland
Posts: 3
MaryLou HB User
Re: Need Advice

Hello Everyone!

Thanks again for all the helpful advice. I spent about half an hour quizzing my doctor on Friday. She is recommending now that I try more physical therapy before I proceed to the discogram. She says my bulge is very small. Since the traction was very painful for me, she has instructed the physical therapist to be less aggressive, starting at a lower weight and proceeding more slowly. Hopefully my primary care physician will allow the additional therapy sessions.

I will also be allowed to take Bextra indefinitely, as long as I have blood work every 4 to 6 months to check on my liver and kidney function.

I also asked her for a back brace to wear when I am doing things where I might mess up my back, so I'm to be fitted for one of these, assuming my primary care physician agrees.

As I noted in my original request, I do not believe my pain is anywhere near what everyone else's seems to be. I do not really have pain during the day, only in the early morning hours, apparently because the bulging disc expands at that time and pushes on the nerve, causing pain to run down my leg. I still have pain while on Bextra, but not as much.

I am definitely a "chicken" when it comes to procedures that involve pain, so I am relieved to be postponing the discogram. It will still be available to me if my back gets worse. I am hoping that I will be able to minimize my pain with my conservative approach. I am also hoping that perhaps the tear will heal (I am an optimist.)

I may also try to find an acupunturist, although this may be difficult as I live on the Eastern Shore of Maryland.

I will still be checking in to see what's going on with everyone. Thanks again for all the information you provided in response to my inquiry and also in the other postings.

MaryLou <IMG SRC="http://www.healthboards.com/ubb/heart.gif">

 
Old 09-29-2002, 03:27 PM   #15
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Join Date: Dec 2000
Location: New York, USA
Posts: 1,709
BAXTER HB User
Re: Need Advice

Hi Marylou,

I wish you well with the physical therapy route.
It works wonders for some people, it just didn't help me.
I appreciate you getting back to us, I was wondering how you made out.
It sounds like you went well prepared to the doctor with a list of questions. I always make sure to have my list handy also.
If you need to talk anytime, just drop me a line.


Keep in touch.

Have a great evening.

Baxter

 
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