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    Old 07-17-2007, 10:40 PM   #1
    erfan
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    Does Mri Confirm Severe Pain?

    What I need to know is if my MRI shows enough damage for me to have severe pain.

    I have seen 4 surgeons...3 said that the damage was too extensive for surgery. The 4th guy felt that because my pain is so severe as to warrant wearing a 100 mcg Fentanyl patch and taking up to 120 mg of oxycodone a day for b/t, that something else has to be wrong-like cancer. But this last guy never looked at the MRI report. He glanced at the MRI itself for a second, and at his xray that I had done there.

    My feeling is that the report-which shows spondylosis, sciliosis, stenosis, modic changes, facet hypertrophy and other impingements-should show enough damage as it is without having to take a bone scan and look for cancer.

    Or, am I being a cry baby and maybe the pain shouldn't be as bad as I feel it is.

    Alan

     
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    Old 07-17-2007, 10:53 PM   #2
    Justoneofus
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    Re: Does Mri Confirm Severe Pain?

    Well you didnt post the actual findings of your MRI.. but if your terms at the next to last paragraph are the findings.. OF course those could all indeed cause you pain.

    I would gather your MRI's and reports and head to a new SPINE surgeon for another opinion.
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    "believe in the beauty of your dreams"- E. Roosevelt

    L5/S1 bulging @ 18, now 46; still there (but no pain)
    Fusion at L4/L5 Apr -2006
    Solidly Fused Nov-2006
    A Success, but still improving!

     
    Old 07-17-2007, 11:37 PM   #3
    Chris54
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    Re: Does Mri Confirm Severe Pain?

    I don't think you can look at a MRI and determine the severity of someone's pain. You can see it in their face. Someone can have a slight bulge and be rolling on the ground in pain and the next have a 9mm bulge and not be in any pain at all. Spondy shows more in an x-ray than a MRI. I realized this 22 months after surgery, on my present appeal for 2nd surgery that I had spondy and that's why I was told that I needed a fusion in the first place. I was never told up front about the spondy. It is painful in itself. I had two torn disc and disc fragments floating around also. I had my fusion surgery in 2005 and I'm now waiting for approval for my 2nd one to go back in and clean it up and remove the hardware. I was injuried twice at work, 2001 and 2002. They took almost 3 years to do the surgery. I went to 8 doctors. Finally the w/c judge ordered the surgery done. Now w/c appeal board is reviewing the case and asking for a second opinion. This just keeps going on and on. I hope you aren't on w/c or a HMO health plan. They will drag this out forever. I already had the bone scan. They did it for C not to see if the bones are solid. They also did a colonoscopy for the same reason. Any reason to get out of surgery cost. I wish you luck and if you can, go on to another doctor. Most doctor's haven't met PAIN.

     
    Old 07-17-2007, 11:40 PM   #4
    erfan
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    Re: Does Mri Confirm Severe Pain?

    Here are the findings...

    Here is the whole story. I had previously seen 3 surgeons, all of whom said I have the back of an 85 year old and that the damage was too extensive for surgery. My PM Doc said let's try a 4th opinion.

    This guy took an x ray and refused to look at the mri report. He said that my pain doc is giving me a ton of narcotics for a herniated disc. He said that the pain must be very bad because I'm getting the meds (100 mcg patch and 30 mg Roxi QID). He would not look at the MRI report which shows plenty of other damage to my back and explains a lot of the pain. Instead, he focused on the herniated discs! He even said that they were causing a problem with the nerves. And then he tested my reflex. My left leg had no reflex response.

    He wants me to do another MRI! I don't get it at all. Here is the most recent MRI report:

    FINDINGS: Small chronic Schmorl's node endplate deformities are seen at several levels and mild Modic type 1 discogenic endplate change is present at L2-3 and L3-4. Mild spondylosis is present primarily ay L2-3. No fracture is seen. There is no spondylolisthesis. There is mild lumbar scoliosis convext to the left.

    The L1-2 disk is partially desiccrated and mildly reduced in height. Small central posterior disk protrusion deforms the thecal sac without narrowing the spinal canal. The neural foramina are patent bilaterally.

    The L2-3 disk is partially desiccated and mildly reduced in height. Small left paracentral posterior disk protrusion is again identified, narrowing the left lateral recess. There is additional contralateral small right posterolateral foramina disk protrusion. There is mild to moderate bilateral neural foraminal encroachment. The canal is within normal limits.

    The L3-4 disk is desiccated and reduced in height. Mild to moderate paracentral posterolateral disk protrusion is again identified. There is underlying posterior disk bulge, facet hypertrophy, mild spinal stenosis and bilateral neural foramina encroachment, mild right, moderate left.

    The L4-5 disk is desiccated and reduced in height. Small central posterior disk protrusion is present. there is facet hypertrophy, mild spinal stenosis and mild bilateral neural foraminal enroachment.

    IMPRESSION
    1.SMALL CENTRAL POSTERIOR DISK PROTRUSION AT L1-2
    2.LEFT PARACENTRAL POSTERIOR DISK PROTRUSION AT L2-3, NARROWING THE LEFT LATERAL RECESS AND NEURAL FORAMEN; CONTRALATERAL RIGHT FORAMINAL DISK PROTRUSION AS WELL.
    3.MILD TO MODERATE LEFT PARACENTRAL POSTEROLATERAL DISK PROTRUSION AT L3-4
    4.SMALL CENTAL POSTERIOR DISK PROTRUSION AT L4-5

    Thanks!

    Again, I currently wear a 100 mcg Fentanyl patch that does nothing, and I use 120mg of oxycodone a day for b/t.

    The way the last surgeon approached me, I felt like a cry baby or a person with a low pain threshold because of the meds I am taking. He also made it seem like my pain HAS to be from other sources if I am in that much pain to require those meds (and I truly am in such severe pain).

    Couldn't the problems in my mri-like stenosis and spondylosis and facet hypertrophy and modic changes account for the severe pain?

    Also, I had no left leg reflex.

    Am I being a cry baby?

     
    Old 07-18-2007, 12:25 AM   #5
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    Re: Does Mri Confirm Severe Pain?

    I would try finding my own Neuro or ortho surgeon (specializing in the spine only) and have them do a total work up. I would get a MRI/contrast if you haven't already and a Cat Scan/dye. When nerve pain is involved the opiate meds do very little. I can't really say on your meds because I can't take anything stronger than class 3 drugs. I was hospitalized twice from Methadone and Oxycotin. I was prescribed 180mg /day of oxy. I have to be satisfied with 8/day of vicodin 10/350 and 2/day of 1mg ativan. I think you need to have some resolution to your problem areas of your back and then they can think about the drug withdrawals and the detox. Has any doctor done pain mapping on you to determine where the pain is coming from? I had no reflex in either one of my ankles before surgery, now I have slight reflexes in my ankles at 22 months post-op. Don't you just love the doctors that say you have a spine of a 85 year old. I was told by one doctor that I was to old to have surgery and that I was to out of shape. I lost 40+ lbs and had a doctor do the surgery that was my age. He didn't think I was to old.

     
    Old 07-18-2007, 05:42 AM   #6
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    Lightbulb Re: Does Mri Confirm Severe Pain?

    [COLOR="Blue"][SIZE="4"][FONT="Comic Sans MS"]After each of my back surgeries, I got a bill for a pathologist, actually my insurance did. When I asked the surgeon about it after my last surgery, he said that they test what is removed for a variety of things including cancer. They do this to be sure that they haven't missed something. So maybe, since you are not getting surgery, they still want to test it.[/FONT][/SIZE][/COLOR]

     
    Old 07-18-2007, 06:00 AM   #7
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    Re: Does Mri Confirm Severe Pain?

    Chris --Boy your right about the strong med's and withdraws. I had major withdraws before on Oxycodone and Morphine and it wasn't fun.
    Do you take the Hydro's with all that tylenol in it ? I been on Hydro's 10MG 3 times a day and from what I here tylenol can shut down your liver or kidneys ? I have ask around if they make a Hydro without the tylenol and found out they do ,I ask my PM Dr. about this and he acted like I was looking for a stronger med or something so I dropped it because I do need what little Pain med's I get for this pain.

    Erfan--I don't see any major problems that gives them a reason not to be able to operate unless they just think it's not bad enough to do ? I'm not saying it isn't painful for you .. Just that Dr.'s don't just want to jump into an operation until they try the least avasive things first.

    I wish you luck. PAIN STINKS

     
    Old 07-18-2007, 07:21 AM   #8
    erfan
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    Re: Does Mri Confirm Severe Pain?

    Shawley, 3 of the 4 surgeons I saw said that the damage was too extensive for surgery.

    Alan

     
    Old 07-18-2007, 10:16 AM   #9
    shawley
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    Re: Does Mri Confirm Severe Pain?

    Alan - Sorry to hear that . Isn't there something they could do for your pain for crying out lowd ? I would be really upset with the technoligy today if they told me that. I feel for you buddy. I'm not saying surgery is a good thing but if there is something wrong fix it..PLEASE ! Have you had steroid injection's or anything ? I sure hope they can make you atleast comphy with all that pain..Around here the Dr.'s hate giving out Med's. I had 3 spine surgeries and 1 spinalcord implant and still suffer with pain and my doc's think I'm ok with the pain ???

    Hope you feel better soon.

    Shawley

     
    Old 07-18-2007, 10:59 AM   #10
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    Re: Does Mri Confirm Severe Pain?

    OMG you poor thing! I too was made to feel like a cry baby coz I was on 120mg oxycodone, 500mg tramadol, 300mg codeine, 5000mg paracetamol, 2000mg naproxen (ani-inflammatory) and muscle relaxants per day and was still in absolute AGONY and almost suicidal. And my neurosurgeon wanted me to stop taking all the meds just to see how bad the pain really was! Can you imagine??? There's a man who has never had any pain himself. The only relief got was thru surgery. Am having a relapse at the moment but staying off the oxycodone coz withdrawl first time around was awful. You have my sympathy and prayers that whatever is causing your pain is pinpointed and sorted out sooner rather than later. Good wishes to all for some relief!

     
    Old 07-18-2007, 11:06 AM   #11
    shawley
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    Re: Does Mri Confirm Severe Pain?

    [QUOTE=NickyO;3106204]OMG you poor thing! I too was made to feel like a cry baby coz I was on 120mg oxycodone, 500mg tramadol, 300mg codeine, 5000mg paracetamol, 2000mg naproxen (ani-inflammatory) and muscle relaxants per day and was still in absolute AGONY and almost suicidal. And my neurosurgeon wanted me to stop taking all the meds just to see how bad the pain really was! Can you imagine??? There's a man who has never had any pain himself. The only relief got was thru surgery. Am having a relapse at the moment but staying off the oxycodone coz withdrawl first time around was awful. You have my sympathy and prayers that whatever is causing your pain is pinpointed and sorted out sooner rather than later. Good wishes to all for some relief![/QUOTE]120MG oxycodone ? Wow that's a strong med no wonder your withdraws were horrible , I took 2 15MG oxycodone and
    2-30MG Morphine a day and when I was taken off the withdraws were horrible. These doc's can't understand our pain . Like to pinch there nerve off to see how they like it !
    Shawley

     
    Old 07-18-2007, 11:34 AM   #12
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    Re: Does Mri Confirm Severe Pain?

    I think if the doctors got their nerves pinched they would be in the ER calling for Dilaudid or something to ease their pain. They even tried to cut me off the Norco and Ativan. W/C sent me to this pain management clinic for 2 1/2 months and tried to talk me out of using the meds for pain. That was after they tried Methadone and Suboxone (Subutex) to take me off Norco. Now does that make since. Hospitalized twice and ER 3 times for pain. No go. Waste of time. That's because my surgeon wanted to remove the hardware. I think they are afraid that the fusion isn't solid. My surgeon even told them that it is. That he would almost stake his life on it. ALMOST, I guess some doubt. I must be getting close to over 1/2 million $$ and they are getting uneasy. W/C told me that I might have to stay on Norco for ever. I want the surgery first. I am not staying on Tylenol for ever. LOL I would probably be turning yellow here real soon.

     
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