Re: no longer relief from pain meds
Hi Val, Pain free isn't a goal of PM, Hence the management part. Even with Intrathecal pumps that deliver, Morphine, Fent or dilaudid, a pump that relieves 50% of ones pain is considered a success. Otherwise you would need ever increasing doses to try to sustain an unrelistic level of pain control.
Succesful surgery doesn't mean it leaves you pain free either, If the lami relieved the neuro problems, leg pain, foot drop muscle atrophy, loss of rtefleses etc. Surgery is considered a success if it's relieves the neuro problems, Remainng back pain is a consequence of back surgery and much easier to manage than the nerve pain or loss of neuro function.
Lamis' can destabalize the spne if multiple levels are done where the spinous process is removed and the joint that prevents forward and backward slippage has been removed. Unfortunately the solution is surgery and again, the goal isn't to relive the pain, it's to stabalize the spine so spondyliotheis doesn't cause cosrd or nerve damage.Further testing is required to DX slippage, instability or spondy. If they resolve the instabilty with fusion, again surgery is a success. Having extremely invasive surgery with or wirthout hardware where the entire spine is exposed and every muscle has been cut is going to cause residual back pain. Perhaps you should discuss the goals of treatment a little further whether it's with PM or surgeoens before procedding with expectations that will never be met aside from a brief honeymoon at every dose increase if't it's substantial enough.
BTW, You have only mentioned one med, I seriously doubt you have reached a point where no other med or increase woould be completely innefective, but if you go in and tell them that the meds provide no relief, the first thought is why are you taking them if they don't help at all. Thye eqsiest way to prove to you that that dose does help is to discontinue it completely, I'll bet you would relaize the meds help much more than you give them credit for. If they truly don't help, Then the docs are right, why take them. What's the point when the expense finacially, phsyically and psychologically is so high if they provide no relief.
Reasonable goals are much easier to meet and docs are much more accomadating when trying to reach a reasonable goal rather than one of being pain free post back surgery.
Good luck, Dave