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blossom64 03-27-2005 09:19 PM

methylprednisone, epidural blocks & fusion?????
I just realized duh that I had an epidural block before I ever left the hospital on day 3 post-op. So I guess if the prednisone & epidurals are a no-no, it's kind of late for me to start worrying about not fusing because of it.

Anyone here had fusion and epidurals, or methylprednisone pills after surgery? What were the results?

My doc said he is going back in to remove my hardware after two years, any comments on this also?

Casey5 03-27-2005 10:28 PM

Re: methylprednisone, epidural blocks & fusion?????
What kind of surgery did you have? Why did you get an epidural before you left?

Why in the world would you have another surgery to take out your hardware if you weren't having any problems with it?


Quietcook 03-27-2005 11:42 PM

Re: methylprednisone, epidural blocks & fusion?????

Don't fret too quickly. Still, this is something that you definitely should discuss with your doctor. I recommend that you not decide against having an injection he recommends until you do so.

What I can tell you is that I've had four fusions with the big one being 10 levels in Dec. Each time I've had fusions, I've had to have steroid injections due to other problems. I've fused completely and in a timely manner each time. I've queried the doc about the injections I've had to have and have been reassured that the amounts I've needed will not affect the fusing. They did not cause me any problems as I was totaly fused within 5 months for the first three. I'll soon be checked at 4 months but the last x-ray showed fusion beginning.

What scares me about steroids is long term use and getting more than 3 injections in 12 months. The reason is that I'm a prime example of the effects of steroids as a chronic asthma sufferer having to stay on extremely high daily doses for more than 2 years before they figured out what was causing the uncontrollable attacks. That did some damage to my bones.

The reason I get concerned when getting more than 3 injections per 12 month period is that I did receive more than injections for tennis elbow (before I became asthmatic) and took a little fall one day. Due to the fact that the steroids made the bones more brittle, (the doc I had at the time and who gave me the injections without any warning) my arm literally shattered. The upper arm was wired together and eventually healed, but the elbow crumbled and I was given a prosthesis which my body rejected. At rejection, the lower arm bones were fused and I lost 3 of the 8 bones in the wrist because without an elbow and stabalization the bones slipped and crushed the nerves as in carpal tunnel. Oh, I have 40 percent use of the arm now, which I didn't with the frozen artifical joint, but that's after going through 10 surgeries so that I could at least write in order to keep my job.

Back in the 70's, which really wasn't that long ago, I was young and didn't know I had the right to demand info from doctors. Mostly, we held physicians as higher beings and didn't ask more than they were willing to let us know. Thankfully that has changed and we now know that we can and should know more, being proactive in our own care.

As far as the hardware, my doc says he leaves it in if is it less than 3 levels being fused as it hasn't caused his patients any problems. With 3 levels or more though, his patients typically request it out at about a year. They are getting more active and the hardware bothers them. I managed to hold out for 17 months, but then it had to go. I do wish I could have held out and left it in, but I am an active person.

This time, he says the 2 rods, 18 screws will remain with the cages as I won't be able to bend so the hardward isn't as likely to bother me. I do hope that it doesn't bother me as this time it won't be a 45 minute out patient surgery to remove this much hardware.

Best wishes and I hope that info will help you a little bit.

Casey5 03-28-2005 01:38 AM

Re: methylprednisone, epidural blocks & fusion?????

I truly cannot imagine what you have been through, especially the last surgery with 10 fusions and now 2 rods and 18 screws. Holy, you must have one very long incision scar on your back and that had to have hurt tremendously after your surgery. I am sorry, I don't know your history, did you have DDD that caused you to have to have all these fusions? How long has it been since that surgery and how are you doing? I hope you are doing well and not in any pain anymore.

>>>Back in the 70's, which really wasn't that long ago, I was young and didn't know I had the right to demand info from doctors. Mostly, we held physicians as higher beings and didn't ask more than they were willing to let us know. Thankfully that has changed and we now know that we can and should know more, being proactive in our own care. >>>

We must be close in age. I could say the very same thing. I could even write a book on my experiences, starting in the 70's until now and how things have changed, thank goodness. Back then I was too afraid to ask any quesitons for fear the doctor would think I didn't trust him. And when I needed to ask questions, I made myself memorize them because I was sure if I pulled out a list he would be really mad at me.

Now I don't go to an appt without my list. And I don't go to doctors who don't spend the time to fully answer my questions and explain everything to me. I have learned there are some bad doctors out there and I don't have to be their patient. There are plenty of good doctors out there too and I now know I don't have to settle for the bad ones. Boy do I wish I had know then what I know now. I am a much better advocate for myself.

Best Wishes,

flyonthewall 03-28-2005 03:46 AM

Re: methylprednisone, epidural blocks & fusion?????
[QUOTE=Quietcook] At rejection, the lower arm bones were fused and I lost 3 of the 8 bones in the wrist because without an elbow and stabalization the bones slipped and crushed the nerves as in carpal tunnel. [/QUOTE]

Which three bones did you loose in your wrist? What was done to fuse it? I have avascular necrosis in my wrist, the scaphoid bone is gone. I have yet to find someone who has had a positive result from having their wrist fused. I just try to get by with bracing.

Quietcook 03-28-2005 07:18 AM

Re: methylprednisone, epidural blocks & fusion?????
Casey and Fly,

Will try to reply to your comments.

First, to Casey, yes it is indeed one tremendous scar down the back. Thank goodness I'm old enough and no longer needing to wear low back gowns, so I don't have to deal with that. The scar begins mid shoulder blade and goes to the very end. The staples down in the butt cheek crack were the most painful I've ever had removed. They would have hurt no matter how gentle the person was and I believe it disturbed the nurse removing the staples almost as much as it did me.

Yes, I have severe DDD, do NOT have scolosis but have some birth bone defects in that my ribs and sternum were caved in and was missing the wings on some vertebrae (cannot remember the proper name), now have osteoporsis, and of course had spondylolisthesis and spinal stenosis and the rest of my support system in the back as far as tendons, etc are also shot. I'm sure I've left something out, but as the doc has said, list every major thing that goes wrong in the back and scolosis is the only one I haven't had to deal with. For that I am grateful.

My surgery was the first week of December, and so I'll hit four months post op next week. Considering what was done during this more than 12 hour surgery in December, I feel like I am making great headway. :bouncing: :bouncing: Still not allowed to vacuum like a normal person until the doc gives the okay. I'm still learning what I can and cannot do. For instance, my friend always helped me with perming my hair. I can no longer bend over a sink to get my head washed and I found that the wash aid I purchased didn't work well since I am so short now. I have lost about 4 inches with all these fusions and the osteoporsis. Right now it is still a learning process of what I can and cannot routinely do, but I can usually figure out a way after somone has to help me a time or two.

As for pain, yes there is still some pain but the Ultram and patches allow me reasonable relief and some totally pain free time. Flexeril helps when a spasm hits, but that's becomming less and less often. Certainly, I'm not dealing with the massive pain that I faced the previous two years. Don't use the Ultram constantly every 6 hours but still use patches daily, so I figure that this is pretty doggone good. I don't want to be on narcotic medications if I can help it, so I'm thrilled that these work for me right now. The narcotics can be saved for the crucial times.

Now, this is not to say that this whole ordeal wasn't extremely painful and trying on this body and my spirit. As I have said in prior postings, the first 2-3 weeks with mind boggling with the pain and the muscle spasms. And, I know that every individual has a different pain threshold, and luckily mine is what I consider a fairly high tollerence. If I had not had such wonderful support from my family and friends I don't know that I would have been able to survive, much less be as far along as I am. One cannot over rate what support means anymore than we can rate what it means to be needed. Surgeries like ours just seem to open our eyes to so many things.

Now to Fly's question about the wrist. When they removed the bones from my wrist, they fused the bones in my lower arm since there is no radial head. The wrist still functions and there was no fusion in the wrist. It is a really weird x-ray to see how the bones are sawed off and then held together. Because back in the 70's & 80's they didn't have the anti-scarring gels which are available now, scar tissue and calcification mounted extremely fast so all the muscles and tendons had to be shortened to remove that and rerouted so as to hold my hand in the supponated position to allow me to type and write. We humans adjust and begin adapting to using the other arm more and more. Actually, I'm am a lot better off than had I totally lost an arm, but when I was in pain from the prosthesis being rejected by my body, I was begging for amputation to get rid of the terrible pain. When I sat and talked with patients though that had just learned they had bone cancer and were going to loose a limb that did not have limited movement, I realized I was so lucky.

I send best wishes to each of you. May your recoveries be as wonderful and as successful as I am experiencing. The year 2005 is going to be a better year for me and I hope for each of our friends here on the boards. The support and sharing here is a marvilous help.

blossom64 03-28-2005 10:57 AM

Re: methylprednisone, epidural blocks & fusion?????
Casey, I had a fusion L4-5 360 degree posterior with instrumentation. He said they generally take out the rods in two years, but I told my hubby if I am feeling fine with it, I am not going to have it done. Enough surgery already! I had the epidural while still in the hospital because of extreme muscle

spasms. I am used to all this, been in chronic pain for over 20 yrs since the first car accident I was in.

Quietcook, good lord dear, you have been through it! :((

My doc said my bones were in excellent shape, very strong and I am in terrific shape despite the soft tissue damage. That comes from skiing, hiking, exercising all my life, so maybe that factor will help with my fusion. I still have skiers legs! I don't feel like I am in good physical shape, ick. I really do trust my doc, he is highly recommended by my primary care physician whom I adore,(they went to medical school together) and all the other doctors I have seen have known him for 20+ yrs. Doesn't do any good for me to fret now over the prednisone, all I can do is pray that the fusion is a success, if not, then I guess I will have to deal with that when it happens.

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