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Old 02-24-2007, 11:53 PM   #1
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Question Need Help PLEASE Re: Incontinence

I have problems at L4/L5 and L5/S1. Previous history: had a MicroD at L5/S1 12/10/04 Etiology undetermined. Prior to surgery was in a wheelchair as I was unable to walk with out falling multiple times throughout the day, and I was afraid of doing MORE damage than was already there. Was doing fine postsurgery, then I MAJOR re-injured it, and the one above cleaning up after Hurricane Katrina. (I know, I know, REALLY stupid, but you just had to be here!) I do have some permanent residual nerve issues which are numbness in the last two toes on both feet, no feeling from ankel down on right foot, and no reflexes in either foot. The nerve had been impinged from Early July 2004 until Surgery 12/10/04. Was trying to avoid a fusion surgery because I "died" during the Micro-D and am VERY scared of the risks involved and what happened during the Micro-D. I react VERY badly to Anesthesia! I have done everything short of Accupuncture since the re-injury to include, PT, ESI injections, Trigger Point injections, etc. Started seeing a PM specialist in February 06. My meds are: Duragesic patch 12.5mcg every 3 days, and Percocet 7.5mg 3X/day as needed for BT pain, and Elavil 50mg at bedtime for sleep/pain. Also suffer from Migraines triggered by Barometric Pressure and take several preventative meds for that including Topamax 100mg/day, Tenormin 50mg/day, and Paxil 20mg/day. I'm also on Estrace 2mg/day for Hormone Replacement therapy due to a Total radical hysterectomy in 1988. My pain levels stay around a 5-7 depending on how much I exert myself any given day. I do work, but my job is not strenuous.

I have an appointment scheduled for 0/13/07 to schedule a surgery date for sometime in May '07 to have the double fusion. I recognize that I can't continue to go on like this. I think for the most part, I've put it off for this long because of the nightmare that happened during my Micro-D.

Here's my question:

This afternoon I had an "accident". I was not able to hold my urination, and the urgencency hit me all at once. It was not like a flood or anything, but definitely enough to have to change clothes. This is the 2nd time this has happened, the first time was just (about 3 days) before my Micro-D). I don't remember the details of the first time, just that it happened before my surgery! When does this "become an emergency"? Both my NS and my PM doctor are "unreachable" after hours and weekends and simply have messages on their answering machine after hours that says go to the ER. What are your experiences regarding incontinenence?

I've read tons on here that says that when it happens it is an "emergency" and so I'm very scared now. But at the same time, I don't wan't to over-react.

With incontinence, is it typical for it to hit you out of the blue?? I've read on here where people have had "leaking" problems, and from what I could tell those were not such an emergency. I just don't know which way to turn, and honestly I'd feel like a fool to show up at the ER, and this be nothing. I'm such a private person. How would you "describe" what leaking is?? Maybe this is what happened to me! I'm just so confused at this point!


I'm so sorry for the long read, and thank you if you have made it this far! I get a lot of information from these boards.

HELP PLEASE
, Anyone!!!

Regards,
Bg

 
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Old 02-25-2007, 12:16 AM   #2
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Red face Re: Need Help PLEASE Re: Incontinence

Dear bg,

I have been one of those discussing "leaking" on the boards recently. I don't know exactly when it becomes an "emergency" but when I told my surgeon on Tuesday the 20th about it, he was concerned. Combined with hip, bottom, leg pain and numbness below the knee, he scheduled me for an emergency discectomy/lamanectomy for Wed. 2-28. His office has since called me and moved it up to Monday the 26th. When I say leaking, I do mean a sudden urge. I've found that it doesn't pay to wait a minute because once I have the urge, most times my bottom doesn't make it to the seat before I start going. When I start going it usually isn't a lot and I can no longer force or control how fast it comes out. Now this is embarresing, but two mornings so far this week I've been awakened by a warm wet feeling that I didn't know was coming. Not enough to wet the sheets, but enough that I need to wash and change bottoms. From what I have read on many different web-sites it is definately considered a red flag for which a surgeon will consider when they decide that you need surgery. Now, I have a question for you because your post scared me a little bit as far as the anestesia. I too have had problems with it, the last time being that they had trouble bringing me out of it. The rest was just extreme nausia and chunk blowing. What happened during your micro d? Did you literally mean that you died?

 
Old 02-25-2007, 02:07 AM   #3
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Re: Need Help PLEASE Re: Incontinence

Hi usta:

I will speak to my surgeon first thing Monday morning. Thanks for your reply.

I'm sorry if my post scared you. I had severe problems because of the anesthesia!! Yes, my blood pressure bottomed out and I flatlined! I wasn't "gone" for long, and I didn't see a white light or anything, if that makes you feel better! LOL! Gotta keep a sense of humor about it!! They didn't have to shock me to bring me back, I got a shot of something, can't remember what now, but it got the ole ticker going again.

I plan to discuss all my concerns about anesthesia when I go in on the 13th. Thanks again for your reply.

I'm sure you'll do fine, keep positive thoughts!

 
Old 02-25-2007, 03:27 AM   #4
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Exclamation Re: Need Help PLEASE Re: Incontinence

Hi there!

I will just say that if you usually do not experience "leaking" or urgency so bad you don't quite make it, I would call NS first thing Monday morning. I waited nearly 48 hours with the opposite issue of not being able to urinate. Which I now know is a sign of major problems as well.

My NS explained that the nerve that controls bladder and bowel sensation was entraped by my slipped disk so if I had waited too much longer I could have had permanent damage and have had to self cath or wear a foley the rest of my life! I thought it was just incontinence I had to worry about so when I couldn't go, I thought it was just my weird body. I am now 13 days post microdisckectomy with major clean up from a previous surgery in the same area.

I can understand your nervousnes about anesthesia, I would be scared as well. You need to talk to anesthesiologist BEFORE you go into the hospital or at least as soon as you know who it will be and make sure they understand the severity of your concerns. Believe me, they don't want that happening to you any more than you do. There must be some other type of anesthesia they can use so that won't ever happen again.

Please don't let your fears keep you from at least pushing to see NS as soon as you possibly can, tomorrow would be great!!!

Here is an to watch over you!

Please let us know what happens, and promise you won't wait very long, you DO NOT want permanent damage to bladder or bowels!!

Hugs and love,
Vickie
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Married 25 yrs to a wonderful man
Many animals, they are such joy
Diskectomy in 1994 L4-5
Re-do emergency L4-5 diskectomy on 2/11/07

Last edited by Jungleland; 02-25-2007 at 03:38 AM.

 
Old 02-25-2007, 04:02 AM   #5
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Re: Need Help PLEASE Re: Incontinence

I pray that you seek medical attention asap and that your neuro/spinal surgeon takes the proper steps to fix this. Take care and keep us posted.

 
Old 02-25-2007, 06:52 AM   #6
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Re: Need Help PLEASE Re: Incontinence

Hi,

You do need to let your doctor know about this as soon as possible. If it keeps happening before you can speak to him, you might want to think about going to the ER. Not to scare you, but it could be caudina equina syndrome, which usually is considered an emergency. This means something is cutting off the nerves in the lower spine..and with sudden incontinence, the nerves to the bladder and/or bowel might be cut off, which can cause alot of damage. It can be caused by disc problems or spinal stenosis. Do you have any numbness down there in your pelvic region? That is another sign of this syndrome. Either way, please do not wait too long to have it checked. Again, I don't mean this to scare you, just to inform you of the possibility. I do hope that it is not serious, though. Please keep us filled in.

 
Old 02-25-2007, 09:22 AM   #7
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Re: Need Help PLEASE Re: Incontinence

I had the same problem hit me, suddenly , out of nowhere, without my my typical 1/2 second, you better find the loo right now warning......and have had it happen almost daily since. I did tell my physiatrist about it and will see my surgeon this coming Friday.
In the mean time , he wants me to see a urologist........what he/she is supposed to do is beyond me, but that's what I am supposed to do in the meantime.
I do have stenosis at two levels L5-S1 and L3-4, and herniations above and below the previous fusion site of L4-5, so I guess we will see what this brings now. Good luck , we share similar symptoms. It is embarassing and frustrating.
Sandi

 
Old 02-25-2007, 09:42 AM   #8
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Re: Need Help PLEASE Re: Incontinence

Is there any males out there who have had this problem?

 
Old 03-07-2007, 08:08 AM   #9
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Re: Need Help PLEASE Re: Incontinence

Ok, gang, I'm here again...and frankly I'm to the point of FREAK OUT now. I'm really getting scared. More than anything I'm REALLY confused.

This is probably going to be a long read, so bear with me. I just need to vent I think.

I haven't done a follow up post, cuz I felt foolish. I did talk to my Doctor (neurosurgeon) the following monday, and he told me to just keep my appointment for 3/13. I called his office, and he called me back that afternoon. He asked me a series of questions first, and told me it didn't seem to be an issue "just yet". Those were his words.

This past weekend I had some problems with some dizziness, and on Monday I had a dizzy spell hit me right before the onset of a migraine. I think that is all that was, just the onset of a migraine. Funny thing is, at about the same time, I was hit out of the blue with an urge to urinate. This time, I didn't really make it completely. It happened twice that morning. I was feeling really "odd" that day. I can't really put my fingers on the words to describe how I was feeling. I called my PCP, since he is the one who handles my migraines, (not the PM) and his office told me to call my Neurosurgeon. So, I called my NS. I told the office clerk, that I had an appointment the next day with my Pain Doc for my monthly visit, as well as I had an appt. scheduled with them on 3/13 to schedule my surgery for early-mid May. I told them what was going on with the 2X that morning with the incontinence, as well as now I have some numbness in the groin area. She told me to "for sure keep my appt. with the PM doc, and for sure keep my appt. with the NS". DUH!!!

That afternoon I got a call from my PM docs office, and the PA that I see discussed with me what was going on. He felt that I should have a Urology consult. He said he would set it up.

Well, I went to my PM appt. The doc did a series of reflex tests. Since my first surgery I have no reflexes in either feet. He did say that the GOOD thing is that I don't have hyperreflexes, meaning my toes don't point or curve upwards when he performs those tests. That could be an indication that the spine is compressed. That reflex test was negative, but he did say, that it didn't mean that the caudna equina nerves wern't compressed, and I still needed that urology consult. He asked if the Urology Office had contacted me for an appointment. At that point, they had not. When I got home, I called that office, and the scheduling clerk had gone for the day.

She just called me back, and the appointment is set for MARCH 26th at 3pm. I called my NS office and talked with them again. They moved my appointment up to this comming Saturday at 4:45 pm. I just didn't think I should wait until 3/26 to see the urologist and figured at the very least my NS could schedule any test to do a "rule out".

I'm freaking out here, cuz I've done my homework. I almost wish I hadn't. I've researched this syndrome, and I'm scared to death.

I do need to say that my PM doc did reduce my Elavil from 50mg to 25mg, saying that perhaps the Elavil could be the culprit.

SYMPTOMS: {Sorry to be so Graphic}

3/5 BLADDER-- Sudden urge to urinate out of the blue. Ability to completly void bladder took a long time, and had to strain. Didn't completly make it to toilet X2, but thought it was because I had on slacks with eyehook clasp. Happened only in morning--got better as day went on.
Numbness in groin area, feels like I have taken a 20 mile bike ride. On inside of left leg. Numbness does not go away though urination urgency does get better as day wears on.
3/5 BOWEL: Constipated as per normal.

3/6 BLADDER-- Pretty much same as 3/5 but only had "accident" X1; Numbness still present
3/6 BOWEL: Bowel moved fine, not as constipated, semi-soft (but not loose)

3/7 BLADDER-- No "accidents", but sudden urge for urination still hits out of the blue so far this morning. Numbness still present.
3/7 BOWEL: No activity thus far today.


HERE ARE MY QUESTIONS:

1) Has anyone else had this complication or heard of this complication from Elavil??

2) From all of the reading/research I've done, everything says go no longer than 48 hours "undiagnosed", so just wondering if I'm going a bit "overboard" or being too aggressive??

3) Has anyone had their NS do any tests to rule out CES?

I'm so sorry this is such a long read. I just needed to get the facts oulined. I guess for my peace of mind more than anything. Bless anyone who has read all of this.

Bg

 
Old 03-07-2007, 09:39 AM   #10
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Re: Need Help PLEASE Re: Incontinence

Bg,
Seems you and I are in a similar boat, waiting for answers for why we have problems with not being able to hold urine. I have lost control of my bladder three times now in the last week and a half. All out of nowhere, all without any warning, all without any urge.
I saw my OSS last Friday, he sent me for an emergency MRI. I had it done. That report says that there is only mild impingement of the thecal sac, therefore no CES. I have read everything that I can find on CES over the weekend, and if there was a posterchild for it at the moment, it would have my picture on it.
I am going to see a neuro on the 13th, same as you apparently, and a urologist. I don't know what either one of them is going to tell me. I do know this much, peeing your pants at my age is not normal. It didn't happen before my fusion or the months after ward. It is new, sudden , out of nowhere.......and there is a reason for it.
I was told that the urodynamic testing done by the urologist will either confirm or not CES. I don't know how true it is.
I am fed up and disgusted. I don't want to be afraid to leave my house.
Good luck BG, keep asking and seeking the answer.......don't give up.
Sandi

 
Old 03-07-2007, 09:51 AM   #11
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Re: Need Help PLEASE Re: Incontinence

Please, please please DEMAND help! When my NS saw me at the ER the night of my emergency microdiskectomy, he asked if I had any incontinence at all. Not thinking that since I was NOT able to go was an issue other than my strange body, I answered no. It wasn't till they were discussing with my husband what to watch out for as they were trying to shove me out the ER door, than my dear hubby said "Look, my wife can't walk, she is in constant pain and now is unable to urinate, what does it take to get her some help?" The NS eyes nearly popped out his head and called for an emergency Urologist consult who ordered a foley cath and they drained out I don't know how many cc's of urine but it had EVERYONE scurrying everywhere to get blood work, get an Emergency MRI (which did NOT show CES!!) and rush me into surgery that night!

Once they were in there, it DID show I had CES and thank God they did the surgery in a great big hurry because I was looking at soon to be permanent damage. I am now 4 weeks out from surgery and urinatin pretty well on my own. They did have to teach me how to self cath, not as big a deal as I thought it was going to be, but I am thankful I hardly ever have to do this.

So, in all this, I URGE you to DEMAND the NS see you immediately. This IS an emergent situation for YOU maybe not the NS!! Don't mean to scare you, just that I have just went through this same thing and I could not imagine my life with a foley cath. Sorry, just too active with young kiddos to have to drag along a bag of urine with me!

I pray they can see you even sooner, you deserve it!

Hugs,
Vickie
__________________
SAHM of 4 kids, ages 3, 9, 19 and 23
Married 25 yrs to a wonderful man
Many animals, they are such joy
Diskectomy in 1994 L4-5
Re-do emergency L4-5 diskectomy on 2/11/07

 
Old 03-07-2007, 10:42 AM   #12
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Re: Need Help PLEASE Re: Incontinence

How do I go about demanding to be seen immediately? I've already called up the NS and moved my appointment from the 13th to the 10th. It was the "earliest" they had. I don't know what else to do. I'm really getting scared here. I'm not seeming to have as many problems today, so what if it is just the Elavil as my PM suggested? I don't know what to do or where to turn? I just turned 47 at the end of last month, and NO at my age, a catheter doesn't seem an option either.

I also am a college teacher, and really do need to finish the semester if at all possible, but I WILL NOT jeopardize my health either. I teach a VERY SPECIALIZED area, and there is no one else to do what I do in my area, but I know we'd get by.

Thanks for your input jungle and sand.

Bg

 
Old 03-07-2007, 11:01 AM   #13
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Re: Need Help PLEASE Re: Incontinence

My 2 cents is to go to the ER now. Dont delay!!

 
Old 03-07-2007, 11:42 AM   #14
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Re: Need Help PLEASE Re: Incontinence

I read your replies to my husband, and he encouraged me to call and demand the doctor call me back this afternoon. When I did that, the office person scheduled me an appointment for this afternoon at 5:45.

I will let you all know what transpires from this appointment. Thank you all so much for your replies. If nothing else, perhaps I can get some peace of mind.

Bg

 
Old 03-07-2007, 11:54 AM   #15
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Re: Need Help PLEASE Re: Incontinence

I am so glad! Please, please let us know what happens. I am sorry if I worried you, just I am so recently "traumatized" by what happened to me that when I read your post, it really concerned me. Thank God the NS will be seeing you today. I would keep logging what is happening and take the log in to NS to show how often and how long this has been happening. Also, be sure to tell him all your other symptoms as well, ya never know what is connected and could be very important info for NS.

Hugs for good luck,
Vickie
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Married 25 yrs to a wonderful man
Many animals, they are such joy
Diskectomy in 1994 L4-5
Re-do emergency L4-5 diskectomy on 2/11/07

 
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