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-   -   Lumbar L5s1 L4/5 Fusion--Bowel Dysfunction. (https://www.healthboards.com/boards/arachnoiditis/616040-lumbar-l5s1-l4-5-fusion-bowel-dysfunction.html)

chevmal283 07-08-2008 06:46 PM

Lumbar L5s1 L4/5 Fusion--Bowel Dysfunction.
 
It has been many years since lumbar double fusion. While I noticed bowel problem (losing control/not frequent voiding) after surgery, I figured due to medication. Since a detox program, I haven't had the ability to have normal bowel movements. While I have neuro bladder since surgery, should one consider the fusion surgery/or injury a factor in bowel dysfunction? Summary of symptoms: Eat, food obviously moves slowly through track, builds up without need to void, then five days pass by, and voiding 10x in one day...this continues on. It's not constipation, it's just not voiding until five or more days. This is very distressing. I have had colonoscopy and endoscopy but no discovery of bowel dysfunction via those means. The Gastro doctor says it is very difficult to prove bowel dysfunction due to back/neck surgery. Is this the case? I've seen many articles suggesting link, but how does one prove it, if it can be? Total of three lumbar surgeries over four years (one cervical double fusion inbetween 2nd and 3rd lumbar) Any suggestions regarded with many thanks.



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lfoster21 07-08-2008 07:32 PM

Re: Lumbar L5s1 L4/5 Fusion--Bowel Dysfunction.
 
I have this problem as well as with my bladder. My Urologist 1st began with testing me for anything that would be non neurological. (Tested my spleen and bladder for thier own problems etc.) He also tried putting me on medication that would have worked, if my situation was just normal age related problems. When all of his tests came back, he dx. me with neurogenic bladder. That was 1 thing that was important for me to prove the connection to my back. Then, that dx. got me a referal to see a Neurologist who specialized in spines. He did and ENG test, which tests for permanent nerve damage. That came back with a noted damage and he then dx. me with a neurological/spinal disorder. It is very inportant to get these type of tests, to get an accurate dx...since there are 2 very serious conditions that are caused by multiple back surgeries.

Then, I went to see a GI, and they did the colonoscopy and another test (can't remember the name) and both came back negative, so that was another piece of evidence, that the bowel problems were neurological. At 1st, my PM Dr. said that the bowels could be do to the meds. or to inactivity or to a spinal problem. But, when I put that together with my bladder, he decided that it was connected to my spine problems.

In my opinion, it is not a GI that I would trust to dx. a spine problem. I would see a Neurologist that specializes in spines or to go back to your back surgeon...as long as he was one that specialized in backs. Otherwise, find someone that does. You want to make sure that you do not have either Cauda Equina Syndrome or Arachnoiditis...both are very serious. Do you have any other symptoms? Any areas that are numb or have odd sensations or any weakness in you lower extremeties?

Good luck and keep us posted.

Lorie:angel:

chevmal283 07-14-2008 09:40 PM

Re: Lumbar L5s1 L4/5 Fusion--Bowel Dysfunction.
 
[QUOTE=lfoster21;3639439]I have this problem as well as with my bladder. My Urologist 1st began with testing me for anything that would be non neurological. (Tested my spleen and bladder for thier own problems etc.) He also tried putting me on medication that would have worked, if my situation was just normal age related problems. When all of his tests came back, he dx. me with neurogenic bladder. That was 1 thing that was important for me to prove the connection to my back. Then, that dx. got me a referal to see a Neurologist who specialized in spines. He did and ENG test, which tests for permanent nerve damage. That came back with a noted damage and he then dx. me with a neurological/spinal disorder. It is very inportant to get these type of tests, to get an accurate dx...since there are 2 very serious conditions that are caused by multiple back surgeries.

I've done this. I don't know that he checked the spleen though. My EMG results, nerve damage yes, but said nothing about connection with bladder. I still wonder about a test of nerves of bladder from spine. I heard the test is out there, but I can't find it.

Then, I went to see a GI, and they did the colonoscopy and another test (can't remember the name) and both came back negative, so that was another piece of evidence, that the bowel problems were neurological. At 1st, my PM Dr. said that the bowels could be do to the meds. or to inactivity or to a spinal problem. But, when I put that together with my bladder, he decided that it was connected to my spine problems.

That makes sense. The other test maybe was endo...

In my opinion, it is not a GI that I would trust to dx. a spine problem. I would see a Neurologist that specializes in spines or to go back to your back surgeon...as long as he was one that specialized in backs. Otherwise, find someone that does. You want to make sure that you do not have either Cauda Equina Syndrome or Arachnoiditis...both are very serious. Do you have any other symptoms? Any areas that are numb or have odd sensations or any weakness in you lower extremeties?

I have the symptoms of both, yet, have never been told I have them. I remember being warned about Cauda, but when warned, it was too late, I had all ready long before that loss control of bladder (many times actually).

The Arachnoiditis, well, I will ask to see a Neurologist...not a Neurosurgeon, correct...to examine current MRIs to see if there is that scar tissue. I know there is scar tissue related to surgeries, but never a mention of Arach. I wonder now, for yes, I suffer pins and needles in arms and legs, loss of use of arms and legs...etc etc etc

I went to my personal physician about bowel symptoms, given 'script for laxative. When I eat, I feel sick. I feel the food, waste, moving slowly through me, is that about what you feel?

This Arach, is it only a case that the scare tissue has to look like a web?




Good luck and keep us posted.

Lorie:angel:[/QUOTE]

lfoster21 07-15-2008 01:02 PM

Re: Lumbar L5s1 L4/5 Fusion--Bowel Dysfunction.
 
I do have that same feeling of the food slowly making its way through my system. I would think that the Neurologist with a spine specialty and the Urologist would be the 2 that would make the final dx. At least, thats how it was for me and it makes sense, since they are the 2 that specialize in nerves and bladders. I am abit concerned that your G. P. Dr. just told you to take a laxitive. My Dr. was so alarmed when I told him that I was continuously taking them. Did your Dr. give you other things to do, in order to get off the laxitives. If you continue to take them, you will find yourself unable to "go" on your own and your body will be dependant on the laxitives.

Did your EMG show a lot of nerve damage or a small amount? This was my problem, because I had all the symptoms, but my EMG only showed a small amount of nerve damage. So, it was difficult to get a dx. at first. 2 of my Drs. said that if I had CES, the nerve damage would be on the high side or even "off the charts".

When you said that you were told about the cauda E. but it was too late, what did you mean by that. It was too late to reverse the bladder problem? Did they dx. you with it but there was nothing they could do to fix it? If that is the case, then the bowel problem is most likly due to the C.E. I may have misunderstood though...that happens;).


Good luck.:angel:

chevmal283 07-15-2008 08:44 PM

Re: Lumbar L5s1 L4/5 Fusion--Bowel Dysfunction.
 
[QUOTE=lfoster21;3648430]I do have that same feeling of the food slowly making its way through my system. I would think that the Neurologist with a spine specialty and the Urologist would be the 2 that would make the final dx. At least, thats how it was for me and it makes sense, since they are the 2 that specialize in nerves and bladders. I am abit concerned that your G. P. Dr. just told you to take a laxitive. My Dr. was so alarmed when I told him that I was continuously taking them. Did your Dr. give you other things to do, in order to get off the laxitives. If you continue to take them, you will find yourself unable to "go" on your own and your body will be dependant on the laxitives.

NO, I have not been told this. And given the amount of years on "fiber power" I wondered if that was a good thing. No alarmed doctor. Heck, after two weeks almost of not going voiding, not much alarm. I have not been given any other direction to go to deal with this on going problem. What should I ask them? I have heard there is a specialist that deals with digestive system but not Gastro--starts with a "P"...I can't remember now. I think it is a specialist.

Did your EMG show a lot of nerve damage or a small amount? This was my problem, because I had all the symptoms, but my EMG only showed a small amount of nerve damage. So, it was difficult to get a dx. at first. 2 of my Drs. said that if I had CES, the nerve damage would be on the high side or even "off the charts".

That is exactly what the case is with me. Small amount according to the EMG, but the electrically pain and pins and needles (saw post on board about pins needles numbness going to read and post) and complete loss of use of legs and arms. It's horrible. So you don't have CES, I'm sorry, I don't have your other post in front of me, I know you said you Arach. (I need to find out more about that) or do you have CES? I was told that CES means there is some lession in you spine (lumbar) in thoracic it's called something else.

When you said that you were told about the cauda E. but it was too late, what did you mean by that. It was too late to reverse the bladder problem? Did they dx. you with it but there was nothing they could do to fix it? If that is the case, then the bowel problem is most likly due to the C.E. I may have misunderstood though...that happens;).

I've had bladder problems since second back surgery (double fusion in '99) but I tried and tried to convince surgeon to send me to urologist, but he didn't . I used own insurance and was told by urologist (this is 2000) that neuro bladder. I gave report to surgeon--twice--along with journals and letter. Well, he didn't ever send to Work Comp. I figured, by what another doc (PM) said, Work Comp not going to cover it. Anyway, I loss control of my bladder in, 2004 I believe. Then it would occur other times. I told my PM but she didn't say anything about it or CES. So then I take my MRI to one of the Spine places that use traction machine. I leave MRIs with them--Retired Ortho and Chiro. They check them. When I return he said you are in trouble. I said what is it? He said something about CES. Now, he didn't say I have it, he said be concerned about getting it. He said if you ever lose control of bladder then get to ER quick--well, it was too late. I think you have 24 hours, if that, to have the necessary surgery to save ya bladder, or stop CES. So that is what I meant, if I have CES, which I'm told I don't, then I have bladder control problems that nothing can be done about. Unless there is and I don't know about it.

So maybe the question to you is, if you have CES, how do you know? Is it seen on your MRI?

And regarding bowels, what other treatment should I being asking doctors about?

And about Arach, is it web only, or just scar tissue first seen, then it spreads.

Do you loss the use of your legs and arms?

I can scratch my arms/wrist and feel the nerves--strange sensation--a bit painful.

I going to post at the numbness pins and needles now.

thanx


:)


Good luck.:angel:[/QUOTE]

chevmal283 07-15-2008 08:48 PM

Re: Lumbar L5s1 L4/5 Fusion--Bowel Dysfunction.
 
Spelling errors are going to occur for I type quickly. And presently it is dark...I'm in a dark room (not much light) and am still wearing my sunglasses (prescription sunwear) for I don't have regular glasses with me. Hopefully all will be able to fill in the corrections.

lfoster21 07-16-2008 03:23 PM

Re: Lumbar L5s1 L4/5 Fusion--Bowel Dysfunction.
 
The fiber powder should not do the same thing. That is one of the things that my Dr. has encouraged me to continue...as well as a high fiber diet. He said that he would also rather me use intermittent enemas (sp?) and suppositories.

I had 2 Drs. (Neurologist/spine and Urologist) that said I had CES. No one at that point had mentioned Arachnoiditis. But like you, my EMG was not as bad, as it usuall would be for CES. So, my other 2 Drs. said there is no way it can be this. They talked to the Neurologist to find out why he thought that is what I had, and he said that I had all the symptoms, esspecially the loss of feeling in my legs/back, the bowel issue and finally loss of bladder control. Those symptoms were enough for him to dx. me with it. But still, the other 2 Drs. said no, it could not be this.

When I asked my PM dr. what else it could be, because I am getting worse all the time, and he just said it was part of the failed back syndrome. But then I read about Arach. on these boards and I did a bunch of searches and printed stuff for my Dr. to look at and when I asked him about it, he said that is what he thought I had...but he did not want to scare me. So, now I have 2 Drs. that say CES and 2 that say Arach.


I am so sorry that you were not able to get your bladder taken care of, when you 1st lost control. My Urologist fianlly found what is working so far, to keep me in control. I take a medication to help me go and I do a self cath. 2 times a day. I no longer have to worry about having accidents!

My understanding is the only tests are the ENG and Nerve conduct test. Then the rest goes by your health history and it is not always known a lot about.

And regarding bowels, what other treatment should I being asking doctors about? Ask your GI Dr. if he knows how you can start to re-train your system, to be able to go more oftern than every week (or what ever it is for you.) Ask why the bottles of laxitives, all say not to take for more than a week. Tell him that you were told that by using them on a daily basis, it would make your bowels unable to "go" on its own.

I was told that you can have an MRI and that the web like picture would show up. I also read on line that somethime they look like dots/spots. I don't know if it always shows up, or just as it progresses.

I have no problems with my arms, but I do have problems with both legs, worse on the right side. I always use a cane, but usually use a walker. It often feels like it takes every bit of effort to lift my leg and place it in front of the other. It makes me want to cry.

I too have odd sensations on my buttocks, and several places on the back and side of my legs. Its like I can't feel my actual touch, but its also feels painful, esspecially when I scratch or rub hard. Some areas I can scratch and not feel anything, but I feel an odd sensation in another area, near by.

I have never heard of this as a symptom, but I have the pins/needles in the tops of both feet and the front of both calfs.


It sounds like we have a lot in common. I will continue to watch for your posts.

Lorie:angel:

tiggertoo2174 07-17-2008 06:57 AM

Re: Lumbar L5s1 L4/5 Fusion--Bowel Dysfunction.
 
I live in the KC metro area and grew up in KCK. About the only option you would have in KCK (unless WC allows you to cross county/city/state lines) is the University of Kansas Medical Center. Most of the large medical centers/pain management Dr's in the area are either in Johnson County KS, or on the Missouri side of the state line. KU Med is about as close to the state line as you can get and still be in KS, it is also the "public" hospital on the Kansas side of the state line.

chevmal283 07-24-2008 03:52 PM

Re: Lumbar L5s1 L4/5 Fusion--Bowel Dysfunction.
 
[QUOTE=lfoster21;3650274]The fiber powder should not do the same thing. That is one of the things that my Dr. has encouraged me to continue...as well as a high fiber diet. He said that he would also rather me use intermittent enemas (sp?) and suppositories.

It's powder--prescription Miralax--Is that ok?

I had 2 Drs. (Neurologist/spine and Urologist) that said I had CES. No one at that point had mentioned Arachnoiditis. But like you, my EMG was not as bad, as it usuall would be for CES. So, my other 2 Drs. said there is no way it can be this. They talked to the Neurologist to find out why he thought that is what I had, and he said that I had all the symptoms, esspecially the loss of feeling in my legs/back, the bowel issue and finally loss of bladder control. Those symptoms were enough for him to dx. me with it. But still, the other 2 Drs. said no, it could not be this.

I read my EMG last night...normal over and over 'cept for in legs for nerves of L5. Note by Neuro says consistant with surgery/injury. I have made an appointment with Neuro with my own insurance to attempt a fresh look at my situation without any interference of prior opinions of docs from W/C side...though not all these docs W/C chosen. I hope he listens and takes close look at MRIs because so far no is saying I have CES or Arach (suspect it though). The EMG is very confusing. How can a person have so much electrical pain and still have clean read out?

When I asked my PM dr. what else it could be, because I am getting worse all the time, and he just said it was part of the failed back syndrome. But then I read about Arach. on these boards and I did a bunch of searches and printed stuff for my Dr. to look at and when I asked him about it, he said that is what he thought I had...but he did not want to scare me. So, now I have 2 Drs. that say CES and 2 that say Arach.


I am so sorry that you were not able to get your bladder taken care of, when you 1st lost control. My Urologist fianlly found what is working so far, to keep me in control. I take a medication to help me go and I do a self cath. 2 times a day. I no longer have to worry about having accidents!

What is the medicine?

My understanding is the only tests are the ENG and Nerve conduct test. Then the rest goes by your health history and it is not always known a lot about.

And regarding bowels, what other treatment should I being asking doctors about? Ask your GI Dr. if he knows how you can start to re-train your system, to be able to go more oftern than every week (or what ever it is for you.) Ask why the bottles of laxitives, all say not to take for more than a week. Tell him that you were told that by using them on a daily basis, it would make your bowels unable to "go" on its own.

Yeah, I need to call him back and set up appointment.

I was told that you can have an MRI and that the web like picture would show up. I also read on line that somethime they look like dots/spots. I don't know if it always shows up, or just as it progresses.

Yeah, I believe I read it progresses.

I have no problems with my arms, but I do have problems with both legs, worse on the right side. I always use a cane, but usually use a walker. It often feels like it takes every bit of effort to lift my leg and place it in front of the other. It makes me want to cry.

I terribly sorry...It's a case of being in bed or walkin' with pain presently. My neck is a mess. Terrible headaches. When I sit, my legs become covered with pins and needles and then just go numb. So painful to move them when that occurs. Constant struggle all day long. Yet, once again, EMG says things normal, so it must be in my head is the vid I'm getting from Insurance (without doubt) and recent new doctors evaluating my case.




I too have odd sensations on my buttocks, and several places on the back and side of my legs. Its like I can't feel my actual touch, but its also feels painful, esspecially when I scratch or rub hard. Some areas I can scratch and not feel anything, but I feel an odd sensation in another area, near by.

I have never heard of this as a symptom, but I have the pins/needles in the tops of both feet and the front of both calfs.

Yeah, the feet are definately the worse of it...not just for the pins and needles though. I have this terrible electical current that runs down shin/ankle/ into feet...I can't stand when it's there. Terrible spasms throughout body. The more activity I attempt the worse for wear. Swimming/pool exercises is about it, but even then.....


It sounds like we have a lot in common. I will continue to watch for your posts.

Ok

Lorie:angel:[/QUOTE]


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