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    Old 03-24-2004, 11:57 AM   #1
    hedycarter1
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    MRi Report and doctors Visit

    Hi Ya'll!

    Okay, so I got my latest MRI report back and this is what it says..

    There is reverse lordosis of the cervical spine centering at c5. The vertebral body height and the disk spaces are preserved excpet for disk narrowing at c56,c6/7. The craniocervical junction is unremarkable.

    c2-3 and c3-4 the central canal and the neural foramina bilaterally are adequantely patent

    At c4-5, there is a broad-based disc/osteophyte complex and bi-lateral uncovertebral arthropathy. This causes moderate to severe right foraminal narrowing

    At c5-6, there is a posterior broad-based disk/osteophyte is seen causing severe right neural foraminal narrowing

    Atc6-7, there is a broad-based disk buldge, bilateral uncovertebral arthopathy, causing moderately severe bilateral neural foraminal narrowing. the cental canal is narrowed but a thin band if CSF is present

    Impression:
    1. Reverse lordosis of the cervical spine centering at c5-6
    2. Degenerative disk disease from c4-5 to c6-7, worse at c5-6
    3. Severe Bilateral c5-6, and moderalty severe c6-7 neural foraminal narrowing.
    4. The central canal at all levels are adequately patent,

    Geesh! that took a while to type!

    Anway, my pain management doctor says that he no longer thinks that I will benefit from ESI's since I had sucka hard time with the last one and I did not get any relief from the last one.

    He says that now I can either live with the pain or have surgery. Can someone tell me what the MRI says?

    He sent me back to my pcp to perscribe my meds, he want to see me in 2 months.

    I don't want surgery, what kind of surgery what it be?

    What now?

    Thanks
    __________________
    DDD, DJD, Nerve inpinchment from bone spurs,disk buldges, forminal narrowing all at c 5/6 c6/7.

     
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    Old 03-24-2004, 03:30 PM   #2
    hedycarter1
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    Re: MRi Report and doctors Visit

    Shore, Backsahurting???

    Anybody?

    Thanks!

    Hedy

     
    Old 03-24-2004, 08:03 PM   #3
    Backsahurtin
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    Re: MRi Report and doctors Visit

    Quote:
    Originally Posted by hedycarter1
    Shore, Backsahurting???

    Anybody?

    Thanks!

    Hedy
    Hey Hedy,

    Sorry I didn't respond earlier to this.

    I really can't help with the MRI results as I'm not very good at knowing what most of the terms mean and have to ask too. I'm sorry. Can anyone else help, please?

    I have no idea what kind of surgery he'd want to do besides maybe a fusion? That's such a scary word, isn't it? When do you see your pcp again? Do you think he would tell you what the pm doc is wanting to do? Could you call them and ask? Maybe ask one of the staff at the pm's office if they could tell you so you can think about it and get more info before you decide. I have such a hard time with doctors who leave their patient's hanging like that! Really gets my goat!

    I would probably try to call the pm docs office first to ask what type of surgery he is considering and if you could get more info about it so you can make up your mind. If you can't get anywhere there, then call your pcp and ask them what the pm doc is recommending you do. Tell them you don't want to go into any type of surgery without having all the information you can get your hands on first. They might think you're agreeing to have it done, but you aren't really. You're just gathering info to make a decision. You won't actually be agreeing to it until they hear the words, "Yes, I'll do it." come out of your mouth and you sign the paperwork. Even then, if you decide at the last moment to change your mind, they have to abide by your wishes.

    If neither of them cooperate, then it's time to start thinking about maybe changing doctors. It took me a very long time to decide to change pcp's myself, I've only seen the new one twice, but I don't regret it as yet. Now I'm also considering changing pm docs too. I really like the guy and how he's treated me but we're having a little difficulty with my insurance approving the scs and he didn't want to discuss other options I might have at my last appointment. I haven't been scheduled for another appointment as yet so I'm going to think about it until I see him again to make up my mind. If he's still intent on doing the scs and doesn't want to discuss other options, then I may change. I hate to think about starting all over with another pm, but sometimes it is necessary so we get the best care that we can.

    Please, let me know what the doc's offices tell you.

    Hugs,
    Ang

     
    Old 03-25-2004, 05:48 AM   #4
    Shoreline
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    Re: MRi Report and doctors Visit

    Hey heady, It sounds like your nPM doc is just a needle jockey if he is dumping you to return to your GP to make a surgical referal. First off, PM docs are not surgeons, Their recoomedations for surgery cary no more weight than my recomendation. IF your GP can't see you for 2 months make an urgent care apt to speed up the process of finding a PM doc that has more to offer than injuections and advice that no surgeon is obligated to follow.

    Many things are considered when doing surgery aside from the actual DX, ability to recover, The damage that's already done, the amount of surgery or number of levels needed to be corected. Lordosis is just the curve in your neck, Instead of curving back your neck curves forward which most likely looks like your head is pushed forward and it would be hard to stand with your ears over your shoulders. Most likely you have a pronounced look with your head in the prone position.

    Can they correct IT, and would that relieve your pain? I really don't know but there are certainly other PM docs out there that can offer more than ESI's. Keep looking for that doc that you can talk with and will take the time to explain what his goals are and what you should expect as far as long term.

    Good luck and keep us posted. Unless you live in Canada, 2 months for a surgical consult is rediculous. What are you suposed to do in the mean time. If you can't get into your GP before two months, the ER may be able to arrange a surgical consult faster than your GP.
    Take care, Shore

     
    Old 03-25-2004, 10:05 AM   #5
    hedycarter1
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    Re: MRi Report and doctors Visit

    Hi there,

    Thanks so much for responding. I can get in to see my PCP any time I want, she is very nice and prescripes my basic meds anyway. What I said was that the PM doc wanted to see me again in 2 months, just to see how things are going. He also is getting me a tens unit, but basically, yes, all he really focuses on is injections and PT, minially invasive stuff.

    I believe that the surgery that he is suggesting is not for the lordsis but for the foraminal narrowing and osteophytes that are pinching the nerves in my neck. I also have a buldging disk that he thinks is causing pain as well.

    What kind of surgery do they do for osteophytes and formainal narrowing? I will call his office and ask, that is good advice.

    Ang,

    how are things going on your end? Can I ask why you have CP? I am actually pretty new to all this, I only started having CP about a year and a 1/2 ago. But I'll tell you, it seems like a heck of a long time....

    How the weight loss going?

    Have you had surgery? What kind?

    Ona personal level, do you have kids? I do, but its a challenge sometimes...

    Here are the problesm that he said could be fixed by surgery and relieve my pain:

    "At c4-5, there is a broad-based disc/osteophyte complex and bi-lateral uncovertebral arthropathy. This causes moderate to severe right foraminal narrowing

    At c5-6, there is a posterior broad-based disk/osteophyte is seen causing severe right neural foraminal narrowing

    Atc6-7, there is a broad-based disk buldge, bilateral uncovertebral arthopathy, causing moderately severe bilateral neural foraminal narrowing. the cental canal is narrowed but a thin band if CSF is present


    2. Degenerative disk disease from c4-5 to c6-7, worse at c5-6
    3. Severe Bilateral c5-6, and moderalty severe c6-7 neural foraminal narrowing.

    I just don't know, I don't want surgery but I dont want to live in constant apin either...

    Hedy

     
    Old 03-25-2004, 05:22 PM   #6
    hedycarter1
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    Re: MRi Report and doctors Visit

    Hey Shore or anybody else that can shed some light,

    Sorry to bother you again but could you take a stab at what surgery they would consider for osteophytes and moderate to severe formanial narrowing? I also have a large disk buldge that I think may be giving me pain as well, I think that it is possible for the disk buldge to heal on its own but I am not so sure that the osteophytes that causing the narrowing will just go away...

    Thanks,

    Hedy
    __________________
    DDD, DJD, Nerve inpinchment from bone spurs,disk buldges, forminal narrowing all at c 5/6 c6/7.

     
    Old 03-25-2004, 08:36 PM   #7
    PsychLea
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    Re: MRi Report and doctors Visit

    Hedy,

    You certainly have alot going on in the cervical area with discs and osteophytes probably compressing on the nerves. What they would probably consider surgically would be a fusion, where they would remove the discs, replace it with donor bone, and stabilize the vertebrae with a plate and screws ...... BUT you would be looking at a triple fusion from the looks of it. Chances are, it may decrease some of your pain, but not all of it.

    Are you experiencing neurological symptoms as well, such as weakness, pain down the arms (radiculopathy), or numbness and tingling? If so, then you would probably need surgery to decompress the spinal nerves and prevent any further nerve damage.

    You need a knowledgeable neurosurgeon or orthospine specialist to walk you through this. I had one fusion, and really need another one at C5-6, BUT my NS is afraid of causing more pain, more spine instability, and feels my best bet would be pain management. However, I don't have any serious nerve compression going on now, and so they are just monitoring it.

    My surgery was worth it, as I was losing the use of my left arm. It does appear that you have some pretty impressive problems going on there and it would be a good idea to get as many opinions as you can so you can make an informed decision.
    __________________
    God bless,

    Lea

     
    Old 03-26-2004, 06:14 AM   #8
    Backsahurtin
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    Re: MRi Report and doctors Visit

    Hi Hedy.

    I just made a pretty lengthy post in the back problems board regarding my condition, but I'll try to give you a brief version here....I have ddd, stenosis in the L4-L5 & L5-S1, sciatic, facet joint arthristis, facet joint arthropathy/disease (isn't that the same thing?), thoracis kyphosis, cervical lordosis, diffuse disk buldging in same area as the stenosis, and degenerative joint disease. I was dx'd in '95 with the ddd, but wasn't told until last year for some reason. The pcp I had been going to before was a real jerk. He'd sent me to this ns about an hour away who was supposed to be the best around. I waited 2 months for that appointment. Was in the waiting room almost 3 hours before getting back to the exam area, waited there another half hour....all for a 3 minute exam! He did that little reflex test, had me take 3 steps forward and 3 steps back, glanced at my MRI, said he was going to order a couple other tests and that was it. I asked if he wanted to follow up in a few weeks after the tests were done and he didn't even take the time to answer me. I asked the receptionist about follow-up and she said they'd get in touch. I did another MRI and a EMG and got a call from my pcp to come in to discuss results with him. He then told me that the ns said it was all in my head and I needed rehab.n I recently got a copy of the letter that the ns sent to my pcp and he said it in that I was overweight, under exercised and addicted to vic's and recommended pain management with emphasis on psychological counciling to get off all addicting pain meds. I was mad about that then got depressed. I'm mad again about it. It's been a vicious circle with my docs so I decided in January that I was changing them and now found a really nice pcp. I've only seen her twice, but she answered a lot of questions I had and showed me on charts and diagrams exactly what is going on. My pm has been pretty good at explaining things as well, but hadn't explained every thing exactly.

    The weight loss is going slowly, but it's still going so that's a good thing. I've lost 24 pounds so far. Would like to lose about 30 more, but if I don't right away I'm not going to worry about it too much. I'll eventually get to the weight I'd like to maintain.

    Been married 16 years, but with hubby for 20 total and we have two children. They're both in their teens now, daughter is 19 and son is 16. Son is wanting me to teach him to drive and sometimes it's a little rough getting him to understand that Mom just doesn't want to leave the house some days. He's not a bad driver for the limited time he's had in the car. I do tend to get a bit more tense and would rather have hubby teach him, but hubby's patience level with him in non-existant, so I try to get him in the car on my 'good' days. A good day for me anymore is when I can actually force myself to take that first step out the door. It's so bad sometimes that I'll stand in the doorway for awhile, then sit in my chair just inside the door, then stand back up for awhile before I finally turn around and go back in. I just can't seem to bring myself to take that step outside for some reason. I really need to talk to the doctor about that but haven't as yet. For the most part, the kids have been really great. They have a hard time understanding but they don't press me to do the things that I used to do with them. When I get upset, they usually end up crying with me. Hubby said it's something to come home and see us in a huddle just crying our eyes out. Sometimes he joins us and has no idea what's going on, just knows it's group hug/cry time. Sometimes it's kinda comical and we're able to laugh about it afterwards. The really bad times, I try to hide the worst of it from the kids but he always knows when it's particually bad.

    I had a CT scan done day before yesterday and found out I've got a cyst on my ovary now. Have to go today for an ultrasound. Doc said they should have the results by Monday and she's going to recommend removal of everything just so I don't have to deal with this again in the future. Had a hysterectomy in '96 because of endometrosis. The gyn I had at that time (he retired last year) decided to leave the one ovary because it wasn't in too bad of shape and he was trying to avoid me having to go on HRT for now. Looks like my luck just ran out on that though. I'm hoping I can still avoid the HRT somehow though.

    I didn't mean to go on so much like that. It just feels so good to be able to share things with people who understand that I tend to ramble on and on. I have to remind myself that others want to share too and I need to stop being selfish and let them share too. I hope to be able to at least provide a shoulder for someone if they need it.

    I'm going to get going for now. I think it's time to lay back down for awhile before that appointment today. Have to also drop off papers at the attorney's office....

    I hope you're having a fairly good day today and that tomorrow is better.

    Take care!
    Hugs,
    Ang

    Last edited by moderator2; 03-27-2004 at 05:48 AM.

     
    Old 03-26-2004, 11:37 AM   #9
    hedycarter1
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    Re: MRi Report and doctors Visit

    Hi Lea,

    Thank you so much for responding. Yes, I do have weakness and burning along with the stabbing pain everyday. My doctor said it is nerve pain. Its a terrable thing.

    Thank you for shedding some light, I kinda figured that the surgery was a fusion. I am pretty you ( 38) and I try to stay active. I really don't want surgery if I can help it.

    I am the sole support of my 2 kids and don't know what i would do if I had to have the surgery, i know that state disability only pays 3/4 of your salary and I barley make it as it is....

    I think that I am going to try a new PM doc first. Kinda get a second opinon. I geuss that I shold see a neuro-surgon as well just to see what he says...

    I am glad to hear that your surgery was a sucess!

    Thanks again!

    Hedy
    __________________
    DDD, DJD, Nerve inpinchment from bone spurs,disk buldges, forminal narrowing all at c 5/6 c6/7.

     
    Old 03-26-2004, 11:57 AM   #10
    hedycarter1
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    Re: MRi Report and doctors Visit

    Hey Ang!

    Wow, we actually have alot in common! i am divorced but I have 2 great kids as well. My daughter is almost 18. I had her when I was a babe myself. And my son is 12. They are great kids.

    I actually hold down a full time job but it is very difficult somdays. The kids try to help out as much as they can but I feel bad I am not the super mom that I used to me.

    This CP has affected my hole life! Most days its all that I can do just to get to work and then do what I can for the kids. Many nights i go to bed in tears from the pain. Some days I wake up the same way.

    I really like my PCp she is great bt I do not feel like she is confortable giving any more meds than she does now. 2 vicodin a 2 just barley makes me able to function. I take one in the am to get to work, sometimes it brings my pain level down to a 5 or a 6 some days it doesnt help at all. I take the other one around 5ish so that I can cook for the kids and help with home work. I am pretty young so I kinda think that most doctors feel as thought I sould not be in as much pain as I am. Or I shold just deal with it. I really do the best that I can but somedays are unbareable.

    I am so gald to know that i have a couple of peopl who understand what I am going through....

    By the way, where do you live? What pain meds are you on?
    Geesh, I am full of questions huh?

    Oh yeah, I am going through a similar thing as you as far as the cyst goes. I have one on my rt oveary that causes me pain and my ob says that she does not like the looks of it. I also am having a biopsy on april 8th becazuse of irregualy bleeding ( constant since dec when I had a ovarian cyst burst) and I have polyps all over my uterus...

    Let me know how it goes!

    Your friend
    Hedy

    I will sent you good thoughts for you appt.

    Last edited by moderator2; 03-27-2004 at 05:46 AM.

     
    Old 03-26-2004, 09:24 PM   #11
    Backsahurtin
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    Re: MRi Report and doctors Visit

    Hi Hedy,

    I don't mind your questions one bit. Can't learn about someone else without them and I've always believed, the only dumb question is the one that remains unasked, so anything you want to ask about is fine with me. If I'd rather not answer, then I'll let you know.

    I live in Ohio. Have for most of my 38 years except when I was a teenager, I lived in a small resort town just outside of Ft. Myers Florida then. I like it here. Winter was kind of cold this year and we had quite a bit of snow, but not as much as I was expecting. The worst time is when it's cold and rainy. Makes me ache something awful, but I deal with it best I can. I spend a lot of time in the bathtub in the hottest water I can stand when I get like that.

    Sounds like your doc is a bit conservative with the pain meds. My new pcp doesn't do my pain meds at all, the pm I go to does that. He had decided not to and had left it up to my former pcp but he wouldn't prescribe because he said it was up to the pm to do that, so after a few weeks going back and forth, the pm took over on the pain meds. He was in complete disagreement with how my case had been handled from the time I reaggreviated my back in Sept of '02. My pcp had sent me to a ns in Columbus (are we allowed to name cities near where we live?) who suggested I go into a pain clinic with emphasis on withdrawal from pain meds as he thought I'm just a drug seeker. His opinion on pain meds is if you don't have cancer, you don't need them. Period! He manages everything with otc tylenol. I just got my med records from my former pcp and was shocked to see he'd put in there that I'd asked for perc's! I never mentioned them once in the 8 years he'd taken care of me. I'm still not quite sure how to react to that. I called to talk to one of the nurses, but she never returned my call, but I did tell my attorney about it today when I dropped some paperwork off. I'm in the process of trying to get SSDI and now I think I know why they keep turning it down, they just think I'm a junkie or something. Neither of them ever thought to do a work assessment to find out what I can and can't do. This new doc I'm going to, that's the first thing she said we should do, so she can get with my pm doc and determine the best course of action for me. I really like her for that! She called him (the pm) while I was still there in the office and introduced herself to him and said she would like to work with him on this so we could get me as comfortable as I can and still function a bit. I think it's going to be a great team now! They are also working on getting me into a local support group and one-on-one counciling so I can learn to deal with the anger I've been feeling lately. Seems if I'm not angry about something, I'm depressed about it. She is a bit leery of adding an anti-depressant at this time since she thinks with the proper support, I'd do fine without them. I currently take methadone and use lidoderm patches for pain, ambien to help sleep (although I still wake up after 3 hrs), singulair and proventil for allergies/ashtma and that's it for now. I had been on vicodin, skelaxin, and bextra, but the former doc took me off all that (cept the bextra, had a reaction to it) on the advice of that ns I saw. I'm still a bit steamed that he said all he did after a 3 minute exam. I tried other meds off and on since '99 but have a problem with the nsaid's for some reason (makes me vomit blood or swell so bad I think I'm going to burst). Was on Neurontin for several months but can't remember most of that time now. Have had a couple seizures since being taken off so I'm a bit scared to go back on it now even though the pcp suggested it. She said she'd let me think about it for awhile but she might recommend it again later. I had been on 2700 mgs a day. They aren't sure what caused the seizures I had, but think it might have had something to do with stress so she said she might do a head ct later after we get this female situation taken care of. I did make it to my appointment today, but won't have the results until Monday. They'll call then to let me know what the results are and also have my appt scheduled with my gyn so I don't even have to call myself to make that appt like the other doc would have made me do. Her office is handling everything. Did get a bit of good news....all my bloodwork came back looking good. She just did a glucose, triglicerids (sp), and cholosteral (sp) check. They said all my numbers were real good. Sugar was 90, tri was 158 and chol was 131. :0)

    My hubby was flabberghasted that the former pcp came in the exam room one time, looked at me and told me I was fat and had to do something about it and walked out. He wanted to hit him and all I could do was cry. That is what finally made me change doctors. I was tired of being treated that way. He never said anything about the weight I'd lost or noticed that I was trying to avoid the pain meds if I could. I'd gladly trade in any pain med for just a week of relief! My biggest goal right now is to be able to go to my daughter's graduation at the end of May and being a proud parent. Right now, I'm scared of the thought of going. I don't want to be in that crowd nor do I want to make a fool of myself by doing my jack-in-the-box routine. Up 10 minutes, sit 10 minutes, pace 10 minutes, then restart. I was made to feel good at one soccer game when my daughter was still playing...the other moms knew I was having some problems, so every time I stood up, so did they, when I paced, so did they. We had to have looked like a clutch of chickens to the other team parents watching us across the field. The coach even go into with us by the end of the season. If I hadn't hurt so bad, I probably would have laughed my hiney off! If I had hooked my arms under like chicken wings, they probably would have done that too! lol That was their way of supporting me which was really nice. I miss them sometimes now that soccer's over. I might try to go to a game next season just to see the ones who still have kids on the team. I missed the entire football season this year though. Football is much more popular than soccer is and the crowd is way too much. I even tried to watch a game from the car last season, but finally gave up and came on home. Good thing my daughter drove that night.

    I don't know how you get through work each day. Wish there was something I could do to help you besides offer my prayers and friendship. I really admire the fact that you aren't giving up although I know you probably have days when you want to. Does your ex help at all, even if it's just taking the kids for awhile so you can pamper yourself or get some rest? I have a real problem with ex's that just disappear and could really get into that, but I won't right now.

    I hope I was able to answer your questions and provide a bit more info.

    Take care Hedy! If there is something I can help you with, let me know and I'll try.

    Hugssss,
    Ang

    Last edited by moderator2; 03-27-2004 at 05:43 AM.

     
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