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Old 09-29-2012, 03:19 PM   #1
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Unhappy Understanding my MRI of Cervical Spine

I know this post is probably going to be long due to the transferring of words from my MRI. I am hoping you dear veterans that have unfortunately gained the knowledge through your very own pain issues are able to assist me in knowing what my longterm prognosis might be. I understand you are not doctors, I have those but they always seem so sly on what to actually tell me. I honestly think my PM doc is as confused as I am. However, this is his specialty as well, the spine and managing the pain associated with it. On Monday I am venturing into the Houston Methodist Center in hopes of finding help and expertise that the hospital brags about. Fingers crossed. Anyone that knows back pain knows PAIN. So, Although you are not doctors, you deal with it physically just like I do on a 24/7 basis.

I am even at the point at requesting a morphine pump, howeveer my PM Doc will not even raise my Morphine dose, which I do understand in a way, but I am the one in constant pain. I can not handle this pain any longer. Right now after seeing my PM Doc yesterday, he has put me BACK on the medrol steroid pack for inflammation, and yes, it does help some however, i do know from past experiences, the pain will be back with a vengenace after the pack is finished, if not before. It is a temporary fix as most are.
I am scared to death of any type of surgery, if that is where this is leading. I am sure anyone and everyone is, especially when it is your spine.

I have Addison's Disease so I am already on Medrol on a daily basis. I swell off and on between 10 and 20 lb fluctuations. My chest is involved somehow as well since I have sever chest pain, not my heart, just chest pain when breathing in and out. My lungs are clear, my PM Doc suggested it is from the spine more than likely as well. I am utterly confused and in pain. My quality of life is almost nil. I think I had three decent days all last month. I know I need not say more since you all are in the boat I am in deep deep in the sea with not many oars if any to get us to the shore where the sun shines in your face and you are pain free. All I ask for is to manage the pain where I do not feel it constantly. Nonstop. Sometimes worse than others. Can't get out of bed. Can barely walk. Afraid to drive. I am 46 years old. I have never really fallen. I do not understand. Told you it would be a very long post, however I am now ranting and need to get to the business part of this post and pray I hear some favorable and positive advice from you all. I wish the same for everyone here, that you all find relief and understanding or maybe some here have already done that and can offer me some hope since I am near to wishing or knowing rather that there are ways out of the constant pain that the doctors have not figured out, yet I have. I don't care what you feel or want to say, I just want and need to hear from you. I feel so very alone and so very much in pain. I have two sons I have yet finished raising and I so want to go camping, fishing, you name it, just like the majority if not all of you wish to do. I want hope. Please, I will not be offended (I don't think) you just answer what you believe. It may not be anything to worry about, that would be awesome. But I want to hear. I am not one to really post on the boards but I do a lot of reading and I wanted to put mine out there since you all seem so knowledgeable. Please help. Thanks in advance for any of your answers or responses. Really, really! On Monday morning by the way, my PM Doc has ordered a complete X-Ray of my entire spine. I am having super bad pain in my lumbar section now. Worse than the Cervical Spine area as of now. See why I am so confused and desperate and most of all SCARED?

OK: The summary (Conclusions) of the MRI I recently had taken, I do have detailed per level, however to spare the length and not have you give up on me I am only going to show the conclusion. This is:

MRI of the cervical spine with contrast:

1. C5-C6 changes of degenerative spondylosis in the form of an osteophyte disc complex causing thecal sac indentation and narrowing of both neural foramina left more than the right with pressure suspected o the left exiting nerve root.

2. C6-C7 changes of degenerative spondylosis and osteophyte disc complex eccentric to the left causes thecal sac indentation and narrowing of both neural foramina left more than right with pressure on the left exiting nerve root.

3. Changes of mild degenerative disc disease in the remainder of the cervical spine.

That is it on the Cervical Spine MRI. I can tell you, most of my pain is on my left side from head to toe. Wierd. I am wondering maybe if I have a pinched nerve. I am not sure of course, as you can see. But I am in constant pain.

I am on Mophine, Medrol, Effexor (for depression of course from the pain), and several other meds. Sometimes the Morphine feels as if I don't even take it, yet I do know if I was to stop taking it, the pain would be out of my grasp, so I do know it does help. I want to take a med like Morphine that kills this pain but doesn't mess up my head and Morphine does not mess up my head but I still live in constant constant constant pain. Especially when I awaken and try to get out of bed. I can barely get a grip and am out of balance and in super pain. The Morphine is 30mg ER three times a day and 30mg IR 4 times a day. I stay on the dosage of all my scripts and never venture for another here or there although at times it is tempting to just gain relief but I will take BC powders or Motrin instead. I am covered in bruises. My thin is super thin, I also have Hashimoto's and take daily Armour for that. I am a mess I know. Please give me your understanding of my writings and offer me with anything that comes to mind or something I am not seeing. Steer me in a direction you think might be of benefit. I am begging for your opinion.

Sincerely,
Elizabeth in need relief in Texas with two beautiful boys I have to see grown.

Thank You Thank YOU! Does not even seem like the right words to say if someone does help me. Anyone that can offer me some insight is an angel for sure
Thats it, and thanks again for reading this very long painful post.

Just to let you know, I do have doctors and pretty good insurance, I am on disability and have Humana.

I have a Pain Management doctor, A Neurologists, An Endo (have Addisons and Hashimotos plus a tumor on my left adreal gland, a Cardiologists(everything good there but high blood pressure occasionally) and a Pulmonologists (have a nodule in my right lung and fight pneumonia all the time due to steroid destroying my immune system ).

So you see, I visit my doctors monthly yet I feel I have gotten nowhere but more diagnoses. The main reason is because I am so very confused at how messed up I possibly can be. Why is my pain so everywhere! This really all started in march of 2009. I am so tired, I mean really tired. I need help. Thank You from all my heart to whom ever reads all this and possibly can respond. You mean so much to me, your words are my friends.

Last edited by Navarresmom; 09-29-2012 at 03:34 PM. Reason: misspelled words, want clarification for the reader to respons accordiangly

 
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Old 09-30-2012, 05:32 AM   #2
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Re: Understanding my MRI of Cervical Spine

NM - I'll assume that you clearly saw nothing at the other levels worth mentioning?

The "thecal sac indentation" that he mentions should not, at this time, be symptomatic. The thecal sac is a membrane that surrounds the spinal canal and holds in the CSF (cerebro-spinal fluid). The spinal cord, which is what really matters, in surrounded by the CSF.

You have a disc osteophyte complex (bone spurs growing backwards off the vertebrae, probably with a bulging disc in between), pushing backward from the vertebral column and indenting the thecal sac. However, that d-o-c is NOT affecting the spinal cord, which is what matters. At least, the radiologist doesn't say it is, and it would be an unforgivable lapse if he missed something like that.

The same d-o-c's are narrowing the neuroforamina on both sides at two levels, worse on the left. Here, the radiologist goes so far as to say that the nerve roots are at least being touched and probably being impinged upon. This would create symptoms on the LEFT SIDE ONLY, and only from the NECK DOWN TO THE HAND. You might have neck pain from this, although your head "shouldn't" be affected. If the symptoms go down as far as your hands, you might feel them in your thumb or index finger, but most prominently in your large middle finger. Symptoms could be pain, tingling, numbness, clumsiness or just a general "sick" feeling. You might also have symptoms on the outside and front of your arms.

All in all, your MRI is not BAD, but it clearly indicates radiculopathy (pinched nerves) at one or two levels on one side. This could possibly be cleared up by an operation called a foraminotomy, which is a fairly non-invasive procedure that comes in from the back-side and clears out the foraminal openings. Some docs might want to do disc-removal-and-fusion (ACDF), but I would get multiple opinions if that's all you hear.

I'm sorry to say that your other symptoms - outside of the left neck-to-hand ones, should not be related to your cervical spine.

Good luck!

 
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Old 09-30-2012, 07:45 AM   #3
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Re: Understanding my MRI of Cervical Spine

Sorry to hear of your pain...

I don't see you mention any type of nerve pain medication like Neurontin, Cymbalta, or Lyrica. This can be very helpful if any of the spurs are touching nerves. This is where an opiate does not touch that type of pain.

And without ever having any type of surgery and only being on Morphine...I don't think there is a Dr. out there that would ok going to an intracthecal pain pump. That is for people who have literally had numerous surgeries to no avail, and have tried every single pain med out there.

So..you are at the beginning of this journey where a possible non invasive surgery can help things..

Have they done any injections? How about physical therapy? Ultrasound massage, acupuncuture, aqua therapy, biofeedback..etc.

I also don't see a muscle relaxer to take as needed. This would be Flexeril, Robaxin, Skelaxin, Baclofen, or Zanaflex. Again...an opiate does not really help with muscle spasms.

These two types of medications for nerve and muscle pain would help you use less Morphine because they will help lower your pain a bit.

It could be that spending so much time at home or in bed has now caused your issues to get even worse. An x-ray of your lumbar area is not going to give them a good view like a MRI will.

Being at a healthy weight, eating properly, drinking water, and not smoking are all crucial in helping pain levels as well as spine issues.

What type of Dr. are you seeing this Monday? You need to be seeing a Board Certified Neurosurgeon or BC Orthopedic surgeon to go over the results of your MRI and take a look at your lumbar area...

You only mention pain though in your back and not a lot of numbness or loss of feeling...do you have this? The downside is that even if you have a bulging or herniated disc in your lumbar area....by laying in bed it will make this even worse. It's one thing to rest for a few days when having a "flare" of pain...

But daily exercise is so important...

I've had 3, two-level, cervical fusions as well as I have active severe herniations right now. Two in my lumbar area and one in lower cervical. As well as stenosis...bone spurs...etc.

But I get up and walk 7 days a week. I have built up to 1.2 miles a day. I'm not fast...but I do it....I also do light stretching and yoga in the am/pm. And I also use a muscle relaxer when needed for bad spasms.

The good news is that 85% of those with spine/disc issues have them resolved non surgically. But you have to be a participant in all the modalities and the more you use...the less you rely on an opiate to bring down all your pain. I only went on MSContin after my 3rd fusion surgery....I had also had foot surgery and a lap for ovarian cysts...

I haven't changed my dosage in over 3 years because I have so many other ways to help lower my pain so it keeps my tolerance from building with my medication.

I'm actually quite surprised by the dosages your PM has you on without any type of severe diagnoses or previous surgeries..

The key is meeting with the type of Dr. I mentioned and seeing if you are surgical..and that can help your issues....or non surgical and then using a comprehensive approach to your pain issues.

There is a difference between regular pain, and pain that is due to an injury or causing more injury. Even with all my issues...I have asked the Dr. what I can do that may cause more pain...but not further injury me. This is why walking is so good even though it may hurt...it's not causing any damage.

So....I truly hope that you can get answers either way with surgery or no surgery...and then either work with this PM or a new one that finds much better solutions for you with all the modalities I mentioned....adding some other medications if needed...and helping you get back to living again. There should be no reason you are living your life in bed and missing out on all the activities with your family..

I wish you luck...

 
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Old 09-30-2012, 12:50 PM   #4
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Re: Understanding my MRI of Cervical Spine

Quote:
Originally Posted by Ilovemycutedog View Post
Sorry to hear of your pain...

I don't see you mention any type of nerve pain medication like Neurontin, Cymbalta, or Lyrica. This can be very helpful if any of the spurs are touching nerves. This is where an opiate does not touch that type of pain.

And without ever having any type of surgery and only being on Morphine...I don't think there is a Dr. out there that would ok going to an intracthecal pain pump. That is for people who have literally had numerous surgeries to no avail, and have tried every single pain med out there.

So..you are at the beginning of this journey where a possible non invasive surgery can help things..

Have they done any injections? How about physical therapy? Ultrasound massage, acupuncuture, aqua therapy, biofeedback..etc.

I also don't see a muscle relaxer to take as needed. This would be Flexeril, Robaxin, Skelaxin, Baclofen, or Zanaflex. Again...an opiate does not really help with muscle spasms.

These two types of medications for nerve and muscle pain would help you use less Morphine because they will help lower your pain a bit.

It could be that spending so much time at home or in bed has now caused your issues to get even worse. An x-ray of your lumbar area is not going to give them a good view like a MRI will.

Being at a healthy weight, eating properly, drinking water, and not smoking are all crucial in helping pain levels as well as spine issues.

What type of Dr. are you seeing this Monday? You need to be seeing a Board Certified Neurosurgeon or BC Orthopedic surgeon to go over the results of your MRI and take a look at your lumbar area...

You only mention pain though in your back and not a lot of numbness or loss of feeling...do you have this? The downside is that even if you have a bulging or herniated disc in your lumbar area....by laying in bed it will make this even worse. It's one thing to rest for a few days when having a "flare" of pain...

But daily exercise is so important...

I've had 3, two-level, cervical fusions as well as I have active severe herniations right now. Two in my lumbar area and one in lower cervical. As well as stenosis...bone spurs...etc.

But I get up and walk 7 days a week. I have built up to 1.2 miles a day. I'm not fast...but I do it....I also do light stretching and yoga in the am/pm. And I also use a muscle relaxer when needed for bad spasms.

The good news is that 85% of those with spine/disc issues have them resolved non surgically. But you have to be a participant in all the modalities and the more you use...the less you rely on an opiate to bring down all your pain. I only went on MSContin after my 3rd fusion surgery....I had also had foot surgery and a lap for ovarian cysts...

I haven't changed my dosage in over 3 years because I have so many other ways to help lower my pain so it keeps my tolerance from building with my medication.

I'm actually quite surprised by the dosages your PM has you on without any type of severe diagnoses or previous surgeries..

The key is meeting with the type of Dr. I mentioned and seeing if you are surgical..and that can help your issues....or non surgical and then using a comprehensive approach to your pain issues.

There is a difference between regular pain, and pain that is due to an injury or causing more injury. Even with all my issues...I have asked the Dr. what I can do that may cause more pain...but not further injury me. This is why walking is so good even though it may hurt...it's not causing any damage.

So....I truly hope that you can get answers either way with surgery or no surgery...and then either work with this PM or a new one that finds much better solutions for you with all the modalities I mentioned....adding some other medications if needed...and helping you get back to living again. There should be no reason you are living your life in bed and missing out on all the activities with your family..

I wish you luck...
Thank you so much for your very quick replies. It surely gives me some options and things to think about.
I am on Zaniflex for the nerve pain given to me by my Neurologists. I do have numbness in my left foot, sometimes don't feel it at all. Everything you describe fits me to a T.
I understand the pain pump being a later type thing, which is really ok with me. Just want relief at all costs sometimes.
I knew the xray would be rather flimsy when it comes to really looking at my lumbar spine. I do have Osteoporosis, I don't know if that causes pain or not. I do have qieut a bit more information listed on the MRI, just listed the conclusion on the former submission. I can list everything said if you are up to reading it and trying to help me.

I really thought the ortho doc would be a route to look into and tomorrow is the day I am going to inquire about this. I do walk daily. Short walks, but walks never the less. I walk my dog at least 6 times a day. Just bought a new puppy and have others so they keep me on my feet.
I never just lay in bed. I do have a very hard time getting out of bed each and every time, so it makes very much since what you mentioned about it making it worse.

I have tried not using the Morphine, just to see if the pain is actually controlled somewhat with its use. I found out that the Morphine DOES help me function. I am absolutely crying in pain and can not walk without the Morphine. My PM Doc has done everything and the Morphine has not come easy.

After about two years of suffering in major pain, which they like to throw in Fibro for, I was hospitilized during an Adrenal Crisis. During the hospital stay the attending doctor put a Morphine patch on my shoulder. Of course I was so unaware of anything with the exception I had became completely pain free during my stay. Upon discharge I asked the doctor what he had done to resolve my pain I had suffered for two years and he replied all he did was put the Morphine Patch on my admittance. I was loopy and out of it. This has happened several times with one time having to call 911 by a family member. I remember nothing. That is the main reason i am seeing the Neurologists, referred by my local hospital.
My immune system is crap due to taking steroids, sometimes at higher doses due to the Addison's Disease. It just rains here but when it starts, it pours.

Let me know if I can list the entire MRI Report and see if you want to make a stab at it. I just don't want to bore you. i am not familiar with most of it so i am unsure what to put down or what you really would like to see. I have also been on Neurontin, Cymbalta, Flexeril (did not help), and recently on Baclofen. Unfortunately the Baclofen did help but I would find myself just falling asleep, very loopy, out of it. I can't do that. My son video taped me while I was on it, I remember nothing and i was sitting there talking to him, laughing and my eyes would just close and open, falling asleep so easily. So, I am super sensitive to these types of meds. i swell like a whale with Cymbalta, but it worked. I loved Cymbalta, felt stable and it did help with the pain. However, it caused too many side effects where the risks outweighed the good. My blood pressure and sugar levels goes through the roof on these meds, so it is not a win win for me. I was on 4 blood pressure meds while on these meds, lyrica, cymbalta, flexeril, Neurontin, and after stopping any or all of them, I no longer am pre-diabetic or have high blood pressure.

I am going to definately look into the doctors you suggested. I am really excited to have those requests. I really appreciate the help you both have submitted my way thus far. Believe me, it is going to be put in great use. I will keep posted waiting on more information. Thank you so very, very much. You have already helped me tons.

Elizabeth, Until we chat again. Thanks again so very very much

Last edited by Navarresmom; 09-30-2012 at 01:12 PM. Reason: added about nerve medications taken

 
Old 09-30-2012, 01:23 PM   #5
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Re: Understanding my MRI of Cervical Spine

Thanks for sharing more..

Just FYI but Zanaflex is a muscle relaxer and not really a nerve pain medication like Neurontin, Lyrica, or Cymbalta...

So...this is something to talk to the Dr. about...

Since no one here is a medical professional...it really doesn't matter with putting the entire MRI on here as you are seeing the Dr. tomorrow...it's all about what they say looking at it and reading the report.

I was diagnosed with Fibro back in 1995 and also have a pituitary tumor...so I can definitely empathize with having multiple issues..

As I wrote before...it's tackling one thing at a time and then for chronic pain management...using as many different modalities as you can to help lower the pain. Unfortunately those of with chronic pain are not meant to be at a 0....A Dr. shoots for about a 5 or so on the pain scale and that is using every single thing I mentioned both medicinally and non medicinally...So the total pain relief you had in the hospital is not realistic unless you have something that can be easily fixed.

This is important to realize so that one does not keep trying to up and up their medications and dosages.

I wrote all that I did based on your first post which said you can't get out of bed...barely walk...and can't do anything with your family. That is great then if you are able to do all the things you said in your second post...

Again...with chronic pain...there is a completely different mindset than with acute pain. There is also a great pain management board here where many of us go to discuss our pain situations so you can post over there as well.

With CP....it's about learning to live at a "new" normal....we may not be able to do every single thing we used to do...but with using all the different modalities....we can live a good life that still brings us joy..

Keep us posted on the upcoming appt...

 
Old 09-30-2012, 01:49 PM   #6
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Re: Understanding my MRI of Cervical Spine

It looks like you posted the Impressions part of the radiologist's report, which should include everything worth considering...

 
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