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  • Parasympathetic sweating after lumbar fusion

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    Old 07-30-2013, 02:59 PM   #1
    dreams08
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    Thumbs up Parasympathetic sweating after lumbar fusion

    I developed extreme sweating in my buttocks/pelvis area after my last lumbar fusion in 10 .The doc would not admit there was even a problem but the PA told me on the phone it was a complication of the surgery and had to do with the parasympathetic nervous system . The PA said there was nothing that could be done about it and that it might get better with time. It was really bad after the surgery, I'd sweat through my jeans . Now 3 yrs later I still have this happen on a fairly regural basis. I saw my gyn ( I am now have incontinence of urine) and suddenly realized my entire pelvic area was wet with sweat . The paper under me was soaked. The doc said nothing, but I was so embarrassed.
    has anyone else had this problem? I also note decreased sensation in pelvic area. It is mild, but it is there. (
    I am having issues with the sacral area, the SI joint. I have tired shots and a rhizotomy but due to hardware already present, nothing seems to help. I am fairly sure there is scar tissue.
    I have been treated like a leeper by the surgeon who did the surgery. If all goes well, great. They will not treat or even admit I have problems from this surgery. If his PA had not told me I would never have known what happened .
    Is there any treatment ? The PA I saw today gave me a brochure for epidural lysis of adhesions. He said it can help scar tissue ,which they say is the main cause of pain after a back surgery. he did not even go near the sweating problem.

    Last edited by dreams08; 07-30-2013 at 03:30 PM.

     
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    Old 07-31-2013, 08:14 AM   #2
    gmak
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    Re: Parasympathetic sweating after lumbar fusion

    Hi dreams, I have a pounding heartbeat apparently caused by sympathetic or autonomic nervous system response, like fight or flight. Cardiologist gave me a benzodiazepene to take for it along with a betablocker & when i took xanax it instantly stopped & the beta blocker helps but i still have it, but more controlled now. I think that this would be a good question for your dr, ob/ gyn or surgeon. If i were you i would check latest or all MRI reports for radiologist statements regarding scar tissue & wording like "clumping of nerve roots" or epidural fibrosis especially before i would consider surgery again & i would get a 2nd opinion from a spine specialist, a spine only neurosurgeon or a spine only orthopedic surgeon to make sure that any diagnosis or treatment that i received would be from the dr with the most training & experience with backs only. I hope that the medicine helps you like it helped me if your dr sees it as a viable option of course.

    Last edited by gmak; 07-31-2013 at 08:16 AM.

     
    Old 08-02-2013, 08:47 PM   #3
    teteri66
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    Re: Parasympathetic sweating after lumbar fusion

    It is the sympathetic nervous system that controls perspiration...and there are things that help some types of hyperhidrosis (at least that's what it's called when there is excessive sweating in palms, feet, face, underarms, etc.) I don't know if any of these things work for your particular problem...but some treatments are botox injections, and a minor surgery. I would encourage you to talk to an internist or a similar specialist to see if your condition is secondary hyperhidrosis, or if it was caused by snipping something in the sympathetic chain during your surgery that does not fall into the category of primary or secondary hyperhidrosis.

    I'm not sure why you didn't discuss this with your gyn. I would think that would be a specialty that would understand this problem. Obviously you aren't going to get reliable info from your spine surgeon. Did you get the operating room notes from your surgery? If not, I would suggest you contact your hospital's "records" dept. and ask for a copy. It might just tell you what, if anything, happened during the surgery.

    Have you seen another spine surgeon for a second opinion and a consultation for your other problems. Since your surgeon wouldn't acknowledge the sweating issue, you may also have some misinformation about your fusion -- whether you are actually fused, whether there might be some other issues that are causing your pain, whether your hardware is properly placed and that you don't have a loose or broken screw or rod, etc.

    Did you discuss the urine situation with your gyn? It very likely could be a cauda equina situation, particularly since you mention now having sacral issues. Please look up "cauda equina syndrome" and see if the description of symptoms sound like what you are experiencing. I'm not saying it's a good idea to self diagnose via the internet...but you should know about CES and should call your doctor if you suspect you might have it.

    I'm sorry my post is so disjointed...I am bouncing from topic to topic, but you brought up several issues and I wanted to address them. The procedure to address epidural fibrosis has a very low rate of "success" and it has or can have some very serious side effects. It is not like getting an epidural injection. It is more invasive than the ESI and can cause additional problems. I would not recommend it at this time, particularly now when I think you still have many issues to explore regarding the fusion in 2010 that may be resulting in the symptoms you have now. I would suggest you look into those first.

     
    Old 08-02-2013, 10:37 PM   #4
    dreams08
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    Thumbs up Re: Parasympathetic sweating after lumbar fusion

    Quote:
    Originally Posted by teteri66 View Post
    It is the sympathetic nervous system that controls perspiration...and there are things that help some types of hyperhidrosis (at least that's what it's called when there is excessive sweating in palms, feet, face, underarms, etc.) I don't know if any of these things work for your particular problem...but some treatments are botox injections, and a minor surgery. I would encourage you to talk to an internist or a similar specialist to see if your condition is secondary hyperhidrosis, or if it was caused by snipping something in the sympathetic chain during your surgery that does not fall into the category of primary or secondary hyperhidrosis.
    The PA told me on the phone that it was the Parasympathetic nervous system and it was a compilation of the surgery and there was nothing that could be done and it might get better in time. I did talk to the surgeon and he denied all of what the PA said and said older women tend to get hip and pelvis issues after lumbar surgery. I was too ill to pursue this much further at the time. It has improved a bit but will suddenly occur like when I was at the gyn office. I did talk to gyn about the incont. and we may do a surgery for that but I will bring up the sweating issue too.
    I'm not sure why you didn't discuss this with your gyn. I would think that would be a specialty that would understand this problem. Obviously you aren't going to get reliable info from your spine surgeon. Did you get the operating room notes from your surgery? If not, I would suggest you contact your hospital's "records" dept. and ask for a copy. It might just tell you what, if anything, happened during the surgery.

    Have you seen another spine surgeon for a second opinion and a consultation for your other problems. Since your surgeon wouldn't acknowledge the sweating issue, you may also have some misinformation about your fusion -- whether you are actually fused, whether there might be some other issues that are causing your pain, whether your hardware is properly placed and that you don't have a loose or broken screw or rod, etc.

    I am seeing an orthopedic surgeon who specializes in the sacral area next week. I am trying to get my MRI's from other doc to bring them with me.

    Did you discuss the urine situation with your gyn? It very likely could be a cauda equina situation, particularly since you mention now having sacral issues. Please look up "cauda equina syndrome" and see if the description of symptoms sound like what you are experiencing. I'm not saying it's a good idea to self diagnose via the internet...but you should know about CES and should call your doctor if you suspect you might have it.

    I will look all of this up and just want to thank you so much. I think if I am armed with some information maybe the doc will take me seriously. what my neuro has said is sacral fusion is not very successful and women tend to end up walking sort of in a squat. I have actually seen this myself so I know that can be true. The steroid injections are not helping and the rhyzomty did not help b/c the doc who did them said I had hardware back there that was interfering with the rhizotomy.

    'm sorry my post is so disjointed...I am bouncing from topic to topic, but you brought up several issues and I wanted to address them. The procedure to address epidural fibrosis has a very low rate of "success" and it has or can have some very serious side effects. It is not like getting an epidural injection. It is more invasive than the ESI and can cause additional problems. I would not recommend it at this time, particularly now when I think you still have many issues to explore regarding the fusion in 2010 that may be resulting in the symptoms you have now. I would suggest you look into those first.
    Thank you so much for your time. I was just so embarrassed at he gyn.I can't believe he did not ask me about it. maybe I need a new gyn. I am afraid the incontinence is going to end up being neurologic and a gyn surgery is not going to help very much

     
    Old 08-02-2013, 10:44 PM   #5
    dreams08
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    Re: Parasympathetic sweating after lumbar fusion

    I posted a longer reply to you teterra but somehow it is gone. I wanted to thank you so much for your information . I am seeing a new doc , one my neuro has referred me to. he specialized in the sacral area so maybe he will know something. I do know that sacral fusions often leave a woman walking in a squat, I have seen this. The gyn has run tests on me and he suggests a gyn surgery for the incontinence .I will probably do this but I fear the real issue is neurological. I will look up what you suggested so at least I will have some info when I see the do doc.
    thanks dreams

     
    Old 08-03-2013, 04:51 AM   #6
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    Re: Parasympathetic sweating after lumbar fusion

    dream08
    sorry to hear all the problems you are having with your surgery....I have sacrum issues but my pain is manageable. I just could not imagine having doctors who are so unsymmpathetic to your plight. Hope the new doctor can get to the bottom of the issues you are having keep us posted as to what you find out.
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    Old 08-03-2013, 08:51 AM   #7
    teteri66
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    Re: Parasympathetic sweating after lumbar fusion

    One word of caution: SI joint fusion is sort of the new kid on the block in terms of new technology regarding spine surgery. Up until recently, most spine surgeons tended to disregard the SI joints as a pain generator. As younger, more recently trained spine surgeons gain prominence, more and more surgeons know the truth about the SI joints.

    A new technique was developed to fuse one or both joints and now it is being pushed as a cure-all for all SI joint pain -- which is of course ridiculous. While many people have SI joint issues, very few actually benefit from surgery. The rate of success is still very low and people are often less well off afterward.

    So what I'm trying to suggest is that if this new doctor specializes in sacral issues, it will be good to go for his knowledge, but be skeptical and do much more research before agreeing to a fusion.

    Again, I think it is much more important that you find out the actual status of the 2010 fusion first...whether the L5 or S1 nerves are compressed and causing your urine incontinence...etc. The gyn. is only looking at an incontinence issue from his training and experience, and is not considering te possibility that in all likelihood it is a result of the fusion and ongoing spine problems.

    Obviously I don't know anything about your particular insurance, but in many cases, people do not need a referral to make an appointment with a new spine surgeon. You might want to find an independent opinion rather than only go to someone you are being referred to by the 2010 surgeon. Try to find an orthopedic spine surgeon who lists "revision" or "spinal reconstruction" surgery as an interest.

    By the way, everything the surgeon said is probably true...but it does not mean that we should just assume that because you fall into the appropriate demographics, we should assume your pain, incontinence, etc. are anything but issues related to the recent fusion. Just as in any scientific experiment, you need to rule in or rule out ONE thing at a time. Do not have gyn.
    surgery until you know the spinal nerves are not causing incontinence.

     
    Old 08-05-2013, 04:51 PM   #8
    dreams08
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    Re: Parasympathetic sweating after lumbar fusion

    hi
    I saw the new doc today and he says I am too heavy for a surgery, ( 5'4-200#) . I appears I am tolerant to opiates as they don't have much effect. He is sending me to a doc who will evaluate me for a pain pump. I felt sad to hear him say I was too fat for surgery. I normally weight about 135 but due to all the steroids and other meds I have gained weight. I feel that if I were 250-300 pounds, yes that is too heavy to go into surgery but I disagree with the weight issue. anyway, all he could at this point was offer me the referral for a pain pump. He said they are using all kinds of things for pain now, not just opiates.
    He said he could see on X-ray that my L5-S1 was almost disintegrated. I told him at times my coccyx area feels like it is free floating in my buttocks area. I can.t even walk when that happens.
    He said for me not to do the epidural liasis of adhesions , He said that what the doc 's said about the Rhyzotomy not working due to the hardware in my back was BS. I wondered about that.
    anyway, no one has ordered an MRI, but he did do Xrays in the office. If the pain pump works, great. that does not solve the problem of the L5/S1 joint. Pain relief is great but if I can't walk, not good.
    so now i wait to hear from the doc who does pain pumps.

     
    Old 08-05-2013, 05:41 PM   #9
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    Re: Parasympathetic sweating after lumbar fusion

    You know, not all spine surgeons adhere to that rule about being too heavy for surgery. If you are interested in trying to have a correction of the problem rather than attempting to find a resolution for your pain, I would suggest you go to another spine surgeon for a "second opinion." I would suggest a fellowship-trained orthopedic spine surgeon rather than a neurosurgeon. They tend to be a bit less fussy and more willing to take on the complex surgeries that others will not touch.

    Last edited by teteri66; 08-05-2013 at 05:44 PM.

     
    Old 08-05-2013, 06:53 PM   #10
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    Re: Parasympathetic sweating after lumbar fusion

    I told him about the parasympathetic buttocks sweating problem and he said in all the yrs as a surgeon he'd not seen or heard of that complication. I told him the PA did not have any trouble identifying it. It was a injury to the spinal cord during surgery they said and nothing could be done and it might get better. It has gotten better, not gone but better.
    I felt irritated that he asked me if I had been fat all my life. I said no I hadn't but was now due to meds and other things, including inactivity. He is a very slim man himself.
    I am going to talk to my neuro who sent me to him. I am going to see if we have any other options.

     
    Old 08-05-2013, 07:47 PM   #11
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    Re: Parasympathetic sweating after lumbar fusion

    Dear dreams, I was in the eye drs office waiting in exam room & i overheard another eye dr say about a lady he had just examined " How can a 43 year old woman say shes healthy if she weighs over 200 lbs" & that had nothing to do with her eyes. So rude. I think if i were you i would keep looking especially because of no MRI to even go by. I have arachnoiditis & its scar tissue induced & its only seen on MRIor CT scan but MRI is preferable.

    Last edited by gmak; 08-05-2013 at 07:52 PM. Reason: info added

     
    Old 08-14-2013, 11:59 PM   #12
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    Re: Parasympathetic sweating after lumbar fusion

    Quote:
    Originally Posted by dreams08 View Post
    The gyn has run tests on me and he suggests a gyn surgery for the incontinence .I will probably do this but I fear the real issue is neurological. I will look up what you suggested so at least I will have some info when I see the do doc.
    thanks dreams
    Hi dreams, The ob/gyn did warn me that cystometric tests were necassarry to be done by urologist to rule out a neurogenic cause of bladder pain & problems. Especially the urethra that needs a IVP to put dye in that shows the "layout" of urthra so that gyn surgery doesnt impede the flow. I truly hope the right treatment is done to help you!

     
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