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    Old 12-15-2004, 10:55 AM   #1
    ladybird988
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    Update on nerve damage: warning

    Hi. I had a microdisectomy 5 1/2 months ago for a herniated disk at L4/L5 that had compressed the sciatic nerve and gave me drop foot so bad that I could hardly walk or lift my leg.

    I thought I'd post my update and latest doctor appointment to help others:

    He explained that some people with nerve compression are fine right after surgery because their nerve sheath is only bruised from the disk fragment resting against it. They rebound quickly. They are the ones that have no more pain right after surgery or very little.

    In my case, the nerve sheath was punctured and has to regenerate, so my recovery is slow. the nerve regenerates at about one inch a month. I asked him to help me visualize that. Did that mean the nerve was short now and would grow down t he leg again to the foot? He said no, the nerve is not short, the sheath covering the nerve is gone and it spirals around the nerve and it is damaged, so it will have to regenerate (grow in a spiral) and will do so at one inch a month, hence the long recovery.

    The sheath is what aids electrical impulses along the nerve giving you motor function, so when it is damaged, strange things happen, like losing muscle strength and ability to lift toes and dragging leg.

    He did not say if the axon or nerve itself was damaged. I guess when you have no more feeling in that nerve, that is an indication of axon damage.

    He said the first year after surgery is where you'll see the most progress and to keep exercising because it's the blood flow that regenerates the nerve, but he said i will continue to improve over 3 years. He also said that with a nerve sheath problem, it is best to exercise but to rest when the pain gets too bad (i rest at level 6 pain or else it shoots to a level 9 and i am down 4 days) because it just inflammes the nerve more. For example, if I continue to walk in level 6 pain, my leg will suddenly go all out weak and I am stranded right where I'm standing.

    I talked to my physical therapist and she reiterated that, and that is why I am still doing baby therapy. She said they only give me one new exercise at a time, so if it casues pain they can stop it and not question which of 3 new exercises is causing the pain. I have very few exercises to do and she is very gentle with the massage. I have just not been able to understand why my recovery is so long. And have been terrified of being disabled the rest of my life.

    She reminded me that I couldn't lift my toes before surgery and when I first started PT, I could hardly lift my leg. So I am getting better a little each month which according to them is right on schedule. And they have big hopes I will recover most of the way. patience is not a virtue of mine.

    What else...he told me to look up nerve sheath to better understand this. The technical term if you are interested is "myelin sheath" and this is refered to as "axonotmesis" (damage to the nerve sheath).

    He says I can hope for 80-90 % strength in my leg in about 3 years, with probably some permanent damage. Right now, 5 1/2 months post op i have 20% strength in the leg, making it hard to get around still. But I am not to walk with a cane, because I have to strengthen that leg and practice balance.

    So, for all you who have leg problems and are better right after surgery, kudos. You are lucky. Some of us have more nerve damage and it takes longer. It has been hard to understand why though. I guess there are two schools of thought: one believes in nerve regeneration and one does not. One believes that nerves regenerate only in the first year and the other cites that it is now proven that nerves continue to regenerate 3, 5 years and even longer. But you have to exercise and keep that blood flowing.

    I do have nerve pain, which he says means the nerve is still alive. I was told by the PT that had I waited any longer to do surgery (I waited 10 days after developing drop foot) I probably wouldn't be walking at all.

    So I am not for surgery generally, but to think that had i waited any longer, by putting off surgery I would lose ability to walk? That's scary and it makes me mad that I waited and now have nerve damage and have a 1-3 year recovery to get through, and in the meantime, I'm disabled.

    So, hope that helps and keeps someone else from getting as bad as I did.

    I have not been able to find anybody on this site, but one person, who has had the leg problem to the degree I do. I have heard from people who suffered permanent drop foot. But I do hear people complaining about leg weakness, pain and drop foot on occasion. So I hope this helps. Messing around with nerves is dangerous.

    Good luck everybody.

     
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    Old 12-15-2004, 11:14 AM   #2
    SpinalMalady
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    Question Re: Update on nerve damage: warning

    Hi LadyBird:

    That was most informative....Thanks for posting that. Can I ask a question?

    How long did you suffer with the nerve issues before you opted to have the surgery??? The reason I ask, is I only let mine go three months, knowing that the nerve was crushed, and dragging my foot behind me...like a stroke victim....

    I would have had surgery sooner probably, because I was in SO MUCH PAIN, but I was teaching college, and in the middle of a semester, and teaching a subject that I couldn't get someone to take over my classes (sign language), so I just put up with the pain, and the dragging foot for the three months and then scheduled my surgery as soon as my students were out. I'm just wondering if I was "short term" or "long term" meaning how long I let it go on?

    Right now I'm not even a week post op...but I'm getting along just fine. I woke up from surgery with no pain in my leg other than a numb ankle and foot. My doctor did warn me (if you've read other post, I apologize, I've said this before) that about two weeks post surgery the nerve could wake up "mad as heck" and the deep hamstring, and calf pain, and buttock pain could return...

    My ankle and foot are still numb, and he said that could take up to a year to come back to life.....

    I haven't started physical therapy yet, obviously, my follow up in not for another two weeks. But I [B]CAN[/B] walk for now and am just praying it stays that way....

    What are your thought? Thanks in advance.

    Hope you keep getting stronger each day. I'll pray for you to continue to have a strong, peaceful recovery..

    Bg

     
    Old 12-15-2004, 11:40 AM   #3
    Rhonni
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    Re: Update on nerve damage: warning

    Lady:
    Thanks for that great post.

    I'm like bgsigns... I have the ankle and foot numbness.

    The way you explain it makes soooo much sense and gives me hope. I know it takes a long time for a nerve to come around, I just need reminding now and then.

    Good info about the blood flow/oxygen though. You can bet I'll be pumping this baby every time it's at rest ... HA

     
    Old 12-15-2004, 11:57 AM   #4
    MARY G
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    Re: Update on nerve damage: warning

    Thanks Lady,
    Mt ankle/foot recovery is very slow. I appreciate your post. Swimming is helping, as is walking. I am almost one year poist 2 level fusion, and I am praying the three year nerve regeneration plan is mine. I am so much better than before...no pain, yea!! The strength and function of my foot is my ongoing challenge. May healing for you be definite and strong. Peace, Mary

     
    Old 12-15-2004, 11:58 AM   #5
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    Re: Update on nerve damage: warning

    Hi, thanks for all of that good information. I had cervical disc surgery after waiting 4 years because of different misdiagnoses and the first year, not really knowing what was wrong. So according to my doctor my nerves were very damaged but not permanently. He also said it would take a very long time to heal, 3-5 years.

    So it's been 2 years since my surgery and I didn't feel much better until the last few months. I feel like it is healing , but you are right it takes so long in some cases. My dr. never explained it as well as yours did, so thanks for relaying that information. Good luck with your healing process.

     
    Old 12-15-2004, 01:36 PM   #6
    bob c.
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    Re: Update on nerve damage: warning

    thank you ladybird,
    i wish my doctor would have explained all that to me.for some reason he is very vague when it comes to post-op nerve damage. i have many nerve related problems since surgery (4 months ago) and i'm always looking for answers or reasons for my pain and did'nt really get detailed info until your post.

    Bob

     
    Old 12-16-2004, 01:32 PM   #7
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    Re: Update on nerve damage: warning

    hi, thanks for your posts. i'm glad i'm not alone.

    In answer to your questions/comments, I did not understand the nerve situation AT ALL, so this week I told him so and MADE him explain it to me better. I have to visualize to understand. I don't think he's used to patients asking for a detailed explanation like that. so, i guess if we want to know we have to tell them so and demand it.

    on how long i went with nerve damage, I dealt with recurring back pain for 3 years (MRI showed bulging disk), and then this January I got pain in the right leg and this time it didn't go away. I was in horrible pain. So that was January. Then I had an MRI I think in March or April and it did show that the disk had herniated and was sitting right on the nerve. However, the doctor said even that could correct itself and as long as I could lift my toes, it was best to give it time to heal, even though I was in horrible pain. I could not lift a juice glass of water without stabbing pain in the spine.

    I did laser acupuncture to treat it and it didn't work. My acupunturist was against a lumbar block and against surgery (he treats people for botched back surgeries on morphine drips) until I got so bad it scared even him and he said, "YOU NEED SURGERY!"

    My leg pain never went away, and then the whole leg, especially the thigh, went numb. I knew I already had nerve damage to the toes. Then one month before the operation, I noticed my leg going weak. I told the nurse and she said that I probably "ONLY THOUGHT" my leg was weak as the compressed nerve can confuse you and make you think the leg is weak so not to worry.

    She was wrong. My leg WAS weak. But I could still lift those toes.

    I then had a major set back and got worse rapidly and the doctor did a lumbar block, saying I had probably torn the disk even more. The block did no good and caused more pain. Four days later i awoke with horrible leg pain. The next morning I awoke unable to lift my toes. i couldn't walk. I called and they got me in immediately to see another doctor, as mine was on vacation. I dragged my leg in to the doctor (I really couldn't lift it at all and needed crutches) and he told me I had developed foot drop which is rare (only happens 2-3% of the time) and I had a 75% chance of recovering use of my leg if I did surgery, and a 50% chance if I did not do surgery.

    I took the first surgery available by my doctor 10 days later. I was about to commit suicide the pain was so bad and I was terrified because now I could not walk.

    I wish now that I had not put off surgery, not taken his advice to wait for surgery, not believed the nurse that I "only thought" my leg was weak. I still wonder if the lumbar block caused part of the problem. The doctor says it didn't. I was already headed to foot drop. So if I was "headed" there, why didn't they operate "before" I got the foot drop???

    I just wish that they had taken this more seriously. Granted, I was all out against surgery, but then when I said I was ready for it, the doctor said he would not do surgery until he had tried a lumbar block and even then, he told me flat out that surgery was a last resort and would just give me more problems in the long run (at least he was honest about that).

    His words were, "If you do surgery, you will just be trading one pain for another. Surgery often causes problems. It's a last resort."

    I'm not a happy camper with the way things went. The physical therapist was enraged that the doctor took so long to do surgery and told me that had i waited one more week, I could have lost all ability to walk permanently.

    So....I can't change things, but I wanted to post to keep someone else from going through what I've gone through.

    What about you all? What symptoms and time frame led up to your foot drop? I know this is long. I'm just in tears and so hurt and angry...and frightened.

    Thanks.

     
    Old 12-16-2004, 01:41 PM   #8
    ladybird988
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    Re: Update on nerve damage: warning

    BG, you say you went three months with foot drop and only have numbness in the foot now? You can lift your leg fine? How strong is your leg percentage-wise?

    I went 10 days with foot drop and at 5 1/2 months post op I have 20% strength in the leg. I'm no longer dragging and can put foot in front of me, but whole leg is weak still.

    Now, the doctor did say that it wasn't a matter of how long the nerve was compressed, as much as it was a matter of how bad the compression was. However, i have heard of people that went less time than you with foot drop who have permanent foot drop. and the PT said it wasn't a good idea to mess around with foot drop and that I should not have waited 10 days for surgery.

    this is so confusing. and I don't want anyone to take what I've written as medical advise, because it's just repeating what I've heard. It's just what happened to me.

    I know what you mean about feeling like a stroke victim. It was a dragging of the leg behind. I was amazed at how much one leg can weigh! I'd go 20 feet and be exhausted!

    It's good to know you are recovering. That gives me hope. maybe my nerve damage was more than yours.

    The pool has been the biggest help to me exercise wise and is a great place to practice balance if your foot is weak.

    Keep us posted on your progress!!!!! Take care.

     
    Old 12-16-2004, 02:06 PM   #9
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    Re: Update on nerve damage: warning

    Hi ladybird:

    Yes it started really [B]BAD [/B] in LATE Sept. with me Dragging my foot....The really bad pain started my first day of school, but had on and off pain all summer, started a new walking regime in the summer....

    The first day of classes, [B]August 23[/B], I came home from Night class, was on my feet from [B]8 am till 10 pm[/B] and I thought my whole right leg was on fire....

    The foot drop/dragging behind me did not start until [B]October[/B],....It finally got so bad that I went in for MRI OCT 5...but I was already well into a semester of College with no one to substitute my classes for me (I teach Sign Language)....I felt that I had to keep plugging along!

    So first I was going to try PM, but the first appt. I could get was 11/22 and I knew [B]THERE WAS NO WAY [/B] I could hang on till then, so I started doing research on the web, stumbled onto Vax-d, and opted to go for a consultation....I did that from Oct 13-Nov 5, with my symptoms getting worse daily....meanwhile still working....MY doctor by this time had me on Percocet 10/325...

    I Discontinued Vax-d with mutal agreement from my doctor, and he sent me for a NS consult, and luckily I got in one week later on Nov 10, and the Doctor wanted me to have surgery the following Friday on Nov 12th...but again, I was by this time trying to prep students for final exams....we agreed to try an ESI...which I had on the 12th, I had my follow up for that on a SATURDAY at 3pm the 20th....Can you imagine a Neuro-Surgeon that works on Saturdays...well mine does...

    He was not happy with my 30% improvement...he wanted at least 50% or more before going on with ESI number 2 or 3....

    On that date, the 20th, he scheduled me for my surgery...Dec.10th...it gave me time to finish up my students...and get my grades posted. I decided to use a wheelchair at school and opted to lecture sitting down, (sitting was best for me [B]NOT [/B] standing), because I was dragging the foot so bad I was afraid I would fall....I did not use a cane, because the cane would trip me...

    Anyway...that's how I got to where I am....

    I am walking great...(for now anyway)...

    I did just try to walk a few hundred feet to the neighbors two doors down with my daughter, and you just don't realize how tired you really are. So I'm glad I didn't try to push it around the whole cul-de-sac....I think I would've paid for that.

    As for measurement of strength of the leg,...I have no idea??? It seems okay, not having any problems lifting it...tone is a little loose, but other than that...seems okay...

    I lost a lot of weight in the process of trying to get from Point A to Point B, and being exahusted, and the pain levels being out the roof, and always having nausea and not wanting to eat...The week of Thanksgiving I lost 13 pounds alone...So yeah...it's a tough haul....

    Good luck to you,...I hope you gain everything back and get strong and healthy soon. Sorry didn't mean to write a book!

    Ladybird, You'll be in my prayers.


    Bg

     
    Old 12-16-2004, 06:23 PM   #10
    MARY G
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    Re: Update on nerve damage: warning

    Ladybird,
    I fell in '98 doing gardening. The very last thing I wanted was surgery. I iced my
    back, did chiro, meds message, etc. I kept working. I was in big time denial. One day at work, one of my patients asked me if I knew I was dragging my foot? I finally went to the docotr, had the tests, and had a micro d ..no impvrment in foot drop. 6 mos later I had a terrible allergy attack and blew out another disc which again impinged on a nerve. I had another micro d. The only exercise I was allowed to do for two years was water walking. When I finally was discharged fron the neuro surgeon, still with foot drop...He told me it would go away, I went to a PT> She said I should have been in PT, not water walking...talk about guilty feelings...by now the podiatrist had me using a mafo brace because I was falling so much, and a cane...That did stop the falling...mostly. 2 years later, I fell again. I did conservative treatment, I had terrible pain, and still had foot drop. I went to pain management, who gave me nerve root injections, to no avail. I went to an OSS who said my l4, l5 and s1 were now completely collapsed, and I needed a fusion. 2 levels. When I woke from the surgery, my foot was not flopping. My leg and ankle are weak, and I am working on strenghtening it...the doctor is amazed, but it is slow. It is so much better than before the fusion. Sorry this is so lomg, nut it is my story of foot drop. Mary

     
    Old 12-16-2004, 11:16 PM   #11
    AlSmith
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    Re: Update on nerve damage: warning

    Bg, I am glad to see you are doing well. Lady bird, that was great information and I appreciate you sharing it with us. I had a micro d 4 months ago and even though I am doing well, I still have noticiable weakness in my leg. I had to take Neurontin for the neuropathy that started up but I recently found out I am losing my job at the end of January so I backed off the dose because it makes me goofy and if I am interviewing for a new job, I have to be all there. I was pleasantly suprised at how much better the pain had gotten. My point is that my nerve seems to be healing and I think you definitely have hope that yours will get better as well.

    I can relate to the stroke reference. I sometimes think my left leg is dumber than my right now. It is almost like right and left hands. I love seeing reports of people here getting better. It can be so frustrating because of the slow nature of the healing but we keep moving forward.

    Alan

     
    Old 12-17-2004, 04:36 AM   #12
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    Re: Update on nerve damage: warning

    Hello everyone. Im a newbe. Here is my story. I have disc herniation in the C4/C5 area of my neck. Lots of sleepless nights. Along with that I have a 8mm nerve root sheath cyst in my L5/S1 region of my spine. This causes lots of back pain . And 3 months ago i was diagnosied with type 2 diabetes. I also stopped smoking due to haveing COPD. None of this is fun at all. All this and only 51 years old. I have the biggest problem with my neck and back with the disc's in the neck and the cyst in my spine. I am new to all this and have no idea what to do or where to go. I just moved from Minnesota back to Cleveland to be near my family last year. I just got laid off so no medical insurance but am getting unemployment so I understand that I can get rated at most hospitals. I would like to know where I should start and where I should go ( Metrohealth in Cleveland? ) I was smart and brought back all my MRI films and my medical files from Minnesota so I do have that. Does anyone else have a nerve root sheath cyst since that is my main concern ? I have my diabetes under control and I know all about the COPD haha. That part of my health is minor at this point in time. Mainly need help with the 8mm nerve root sheath cyst.

     
    Old 12-17-2004, 04:37 AM   #13
    cleve60
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    Re: Update on nerve damage: warning

    [QUOTE=ladybird988]Hi. I had a microdisectomy 5 1/2 months ago for a herniated disk at L4/L5 that had compressed the sciatic nerve and gave me drop foot so bad that I could hardly walk or lift my leg.

    I thought I'd post my update and latest doctor appointment to help others:

    He explained that some people with nerve compression are fine right after surgery because their nerve sheath is only bruised from the disk fragment resting against it. They rebound quickly. They are the ones that have no more pain right after surgery or very little.

    In my case, the nerve sheath was punctured and has to regenerate, so my recovery is slow. the nerve regenerates at about one inch a month. I asked him to help me visualize that. Did that mean the nerve was short now and would grow down t he leg again to the foot? He said no, the nerve is not short, the sheath covering the nerve is gone and it spirals around the nerve and it is damaged, so it will have to regenerate (grow in a spiral) and will do so at one inch a month, hence the long recovery.

    The sheath is what aids electrical impulses along the nerve giving you motor function, so when it is damaged, strange things happen, like losing muscle strength and ability to lift toes and dragging leg.

    He did not say if the axon or nerve itself was damaged. I guess when you have no more feeling in that nerve, that is an indication of axon damage.

    He said the first year after surgery is where you'll see the most progress and to keep exercising because it's the blood flow that regenerates the nerve, but he said i will continue to improve over 3 years. He also said that with a nerve sheath problem, it is best to exercise but to rest when the pain gets too bad (i rest at level 6 pain or else it shoots to a level 9 and i am down 4 days) because it just inflammes the nerve more. For example, if I continue to walk in level 6 pain, my leg will suddenly go all out weak and I am stranded right where I'm standing.

    I talked to my physical therapist and she reiterated that, and that is why I am still doing baby therapy. She said they only give me one new exercise at a time, so if it casues pain they can stop it and not question which of 3 new exercises is causing the pain. I have very few exercises to do and she is very gentle with the massage. I have just not been able to understand why my recovery is so long. And have been terrified of being disabled the rest of my life.

    She reminded me that I couldn't lift my toes before surgery and when I first started PT, I could hardly lift my leg. So I am getting better a little each month which according to them is right on schedule. And they have big hopes I will recover most of the way. patience is not a virtue of mine.

    What else...he told me to look up nerve sheath to better understand this. The technical term if you are interested is "myelin sheath" and this is refered to as "axonotmesis" (damage to the nerve sheath).

    He says I can hope for 80-90 % strength in my leg in about 3 years, with probably some permanent damage. Right now, 5 1/2 months post op i have 20% strength in the leg, making it hard to get around still. But I am not to walk with a cane, because I have to strengthen that leg and practice balance.

    So, for all you who have leg problems and are better right after surgery, kudos. You are lucky. Some of us have more nerve damage and it takes longer. It has been hard to understand why though. I guess there are two schools of thought: one believes in nerve regeneration and one does not. One believes that nerves regenerate only in the first year and the other cites that it is now proven that nerves continue to regenerate 3, 5 years and even longer. But you have to exercise and keep that blood flowing.

    I do have nerve pain, which he says means the nerve is still alive. I was told by the PT that had I waited any longer to do surgery (I waited 10 days after developing drop foot) I probably wouldn't be walking at all.

    So I am not for surgery generally, but to think that had i waited any longer, by putting off surgery I would lose ability to walk? That's scary and it makes me mad that I waited and now have nerve damage and have a 1-3 year recovery to get through, and in the meantime, I'm disabled.

    So, hope that helps and keeps someone else from getting as bad as I did.

    I have not been able to find anybody on this site, but one person, who has had the leg problem to the degree I do. I have heard from people who suffered permanent drop foot. But I do hear people complaining about leg weakness, pain and drop foot on occasion. So I hope this helps. Messing around with nerves is dangerous.

    Good luck everybody.[/QUOTE]

     
    Old 12-17-2004, 04:44 AM   #14
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    Re: Update on nerve damage: warning

    Gosh Im sorry to hear about this . I have been diagnosed with an 8 mm nerve root sheath cyst and have alot of problems with it. I need to go to a DR. here in Cleveland. I have back pain, urinary problems (although minor for now) and all around confusion on this type of cyst. What to do and where to go for help type thing. I also have Degenerative Disc Desease so that doesnt help. I was told that I could end up with Drop foot in time and I have notice that I have started the tripping over my own feet . Kinda dragging the top of my right foot but not all the time but more then a normal person would do . I have a very hard time climbing stairs without back pain. I am not on any thing for it other then asprin. Just moved to Cleveland from Minnesota and have no health insurance now due to lay off so not sure what I should do. I do have all my MRI films and medical file so was told that Metrohealth is the best place I should go but not sure what to ask about my condition or what to expect with this medical problem as time goes on... I would love any ones ideas on this matter.

     
    Old 12-17-2004, 01:05 PM   #15
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    Re: Update on nerve damage: warning

    Wow, great posts!

    BG, your leg could just be weak from not using the muscles. You may not have a weak leg from nerve damage. the physical therapist says that my leg weakness is partly due to nerve damage that should heal and partly due to the fact that the leg hasn't been exercised much for months before surgery. It's amazing how quickly you lose muscle tone.

    Let's hope that your leg weakness is just unused muscles.

    I did see from your post that your surgeon did take your drop foot seriously if he wanted to do surgery two days later.

    I have to say that i think now that I got more than just drop foot. My foot flopped. i couldn't lift the toes or foot at all. it just hung there. I had no strength in it to push on the gas pedal. As for the leg, I could hardly move it. So I was literally dragging the leg behind me. i could not put my foot forward. It just flopped. I have seen others with foot drop but they can actually walk around.

    After hearing the post about the ongoing years of back and foot problems, and that surgery years later helped the drop foot, that was GREAT! Talk about hopeful! I hope you heal all the way and regain your foot and leg strength! No more falling!

    Great stories.

    I didn't mean to scare anyone. I just didn't want anyone else to wind up like me by not taking the leg weakness seriously enough. These posts are hopeful and helpful. Thanks.

    On the cyst thing, all I can say is I read somewhere that if foot weakness develops or loss of bowel or bladder function with a spine problem, that it's time to see the doctor as these are serious red flags. I would at least see a back doctor on those symptoms. good luck.

     
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    visual vertigo update Billy2310 Dizziness / Vertigo 65 02-07-2005 01:47 PM
    Help - need info on nerve impingement LS56 Back Problems 4 04-21-2004 08:26 PM




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