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    Old 05-12-2006, 12:38 PM   #16
    shawley
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    Re: Calling for Shoreline's help

    Thanks Dave , I just got home from my surgeon , he said " After looking at the x-rays everything looks ok , I said , why would a w/c doctor write in his report that I have no sign of fusing what so ever ? He said he must be a quak because you are fusing (who to believe ? ) Then I said why am I having all this pain in my legs , he looked at the CT and said I can't see any pinched nerves , that it MIGHT be scar tissue making the pain ? BUT he also said it sound like a pinched nerve so he set me up with a MRI on the 16th . He said if it is scar tissue he would clean it out. How is that surgery ? Thank's so much Dave .

     
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    Old 05-15-2006, 12:13 PM   #17
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    Re: Calling for Shoreline's help

    To my understanding scar tissue removal isn't that bad , right ? I mean if it's all scar tissue problems I may as well go through with it right ? Or maybe I have a pinched nerve or somthing , I'll find out tomorrow if its a pinchy . When my surgeon showed me my x-ray and said look here is bone forming I didn't see anything ??? Looking at the x-ray I can see a big hole between my vertabra ( laminectomy ) and there's no bone in it ? Sorry for being a pest.

     
    Old 05-15-2006, 02:09 PM   #18
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    Re: Calling for Shoreline's help

    The problem with scar tissue removal is it usually comes back even worse then before something I can attest to.....Dave

     
    Old 05-15-2006, 02:15 PM   #19
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    Re: Calling for Shoreline's help

    That's cool, I don''t mind. I's nice to see someone with some hope.Dependding on how they did your fusion, using bone chips, plugs or grindning it into a paste,each method has a slightlkly differently looking look, 6 months out or even 1 year out large plugs or frags will still show in the Xray, so will paste but it has a very different loooking signal than the vertabrea they are supposed to be fusing. Even if there is bone to be seen, they don't know if it's live bone and thriving or dead bone slowly being reabsorbed. There isn't a test that will determine that. I don't usuallly give radiologist reports much credit, thesurgeonsopinion s what determines what appens. But if something clearly isn't there, I don't see how that can be interpreted differently. It's not like missing a fracture or not catching everyting. You wuld hink if it's there it's there.

    As far as surgery to remove scar tiisue, that's contreversial too, you could always scar again and if your prone to heavy scarring you could end up in the same position. There are enzymes now they paint the fresh incisions with to reduce scarring which should help. Anoter advanatage is he will likely check the integrity of the fusion if he's going back in. When they went in 3 years after my first fusion, docs had been elling me everthing was godod, it was all in my ead, learn to live with it, etc etc. It wasn'
    t untill the hardwares snapped did they truly belive there was a mechanical problem.

    Flexion and extension Xrays are a big determining factor n callng a fusion a success. Bend forward and bend back wards, and if evrything stays in alignnmnet they call it a succesful fusion. BUt the hardare alone may be holding each vertabrea in place. If there isn't a fusion, that';s putting more tahan the initial year or so the hardware is designed to hold each vertabrea in place while it fuses.

    After I sheared the heads of 3 screws they did go back in, it took 4 hours to get to my spine because they disec5ted all ehe acar tissue they could and he poked the initial fuison material and it flasked out like dried fish in his words. It would have still given a radiological signal and showed that it was there, but it was dead andit took 3 yars and actually breaking the hardware to get back in and confirm it had been a failure from the get go.

    It may be harder to get someone to declear a fusion a failure at 6 months, but if he's going in to rem,ove scar tissue, he shuould be able to get a toll in there to check the fusion material and check the integrity..

    If you trust a the doc to remove scar tissue you may as well give them consent to revise your fusion if it's failed. It would be better than waking up to find you need a fusion, which happened to my friend. He was just supposed to have disc surgery and the doc wouldn't do the fusion he needed once he got in there and saw how bad things were. He trimmed th discs, but still needed a fusion but the doc wasn't going to do it without consent. So his spine muscles went through two major traumas which is a big component in recovery. Lots of superman excerccises to fix that. lol

    I wouldn't want to go that route. Just fix it if it needs fixing if your comfortable with his methood of fusing if you ask what will you do if you find there isn't bone growth and only the hardware is hoding your spine in place for now. It may hold it for years, or it may snap.

    If you have you Xrays, they usually fill the space between the facets with bone and rough up the pedicle or the facets to cause them to blead on the donar bone. SO the sides are where you would see fusion material.

    If you can get a couple more opinions in the next few weeks, gather all the info you can so you feel as educated as possible abotut your decision. Comp docs aren't prone to contradict each other but your own docs may have a differnt opinion than a comp doc, you just have to pay fo them or get regular nsurance to cover it. You have to be demanding when it comes to explaining why one doc sees X and the other Y.

    Too bad we can't post pics. Oh well, Take care and have you checked out spine U, it's a must. You can see what a posterior fusion is supposed to look like and likely find comparision photos of a failed fusion and a solid. You can also see the hardware used in front Vs back approaches and the results of some case studies and results with each set of hardware or aproach to each surgery.

    Did you wear a hard shell brace after your fusion? I have read where some folks don't and return to work in 60 days. The doc that did my last would have preferred a body cast just to ensure no movement occured while I was supoosed to be fusing. I did have an external Bone growth stim but there is an internal one they remove after a year. There are quite a few variables that a doc may use or not. I figure the more things you have to ensure a solid union, the better.

    A body cast just isn't practical with tubes and devices everywhere to drain #@#@. But I am shocked some docs don't use bracing post fusion just like I'm shockes some docs don't use PT post fusion and just tell people to walk. With all a PT can do if they are good, it doesn't make sense not too.

    When they molded my last brace, which was just a plaster wrap, it felt great when it dried. IT was such a relief to be in the right alignment and to let the cast do the work after 3 years of trying to hold it together myself with physical training, posture and core strength

    I do think I may have hit a brick wall with my effort to strengthen my core and endurance and get my life back. I can do 4 miles on elyptical walker and keep moving aerobically for 50 minutes. I've come along way since starting at 8 minutes 3 months ago, but I'm shot for the day and pay for it heavily. That's a whole nother topic I may post about having to accept that this is as good as it will ever get.

    Anyway, although surgery to remove scar tissue is contreversial, hopefully they have continued to advance in the field of bio agents to prevent scarring. It will get someone in there to physically check your fusion, so it may be worth while if your having alot of nerve/leg pain. Personaly I would want a doc to show me, I'm not from OK, lol but knowing they are going in for something specific you expect to feel better from would be a must for me. IF you can handle waiting for a couple more opinions, I would get both a NS and an OS opinion.

    Good luck, Dave

     
    Old 05-16-2006, 05:26 AM   #20
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    Re: Calling for Shoreline's help

    Hi Dave , I wore a brace for 3 months after both surgeries. My Dr. did show me where the bone was supposed to be fusing , on the sides of my spine by my screws , I did look a little milky looking in a small area . I think I'm going to get another Dr. to check it out. But you wouldn't believe how hard it is here in PA to get another Dr. other than the one who did the surgery to look at you , insurance for Dr's is expensive here , because of lawsuits . If it wasn't for flyonthewall ( I met here ) I wouldn't of found my OSS. I go for my MRI today maybe it will show a little more of my problem ,isn't it somthing when you know there is somthing wrong with your body ? I keep telling my wife I am not nut's , there is somthing that can be fixed , she keep's telling me I'm going to have to live with pain. I'm only 40 years old for crying out lowd.
    I will try hard as I can for more opinions , I will have to look many miles from home tho. Right now I travel 2 and a half hours to my doc , with the price of gas...? I told my doc in the getgo , if there's somthin wrong fix it , I will tell him if he see's a bad fusion fix it , he did once , he was supposed to remove my broken screw and replace it ,he ended up replaceing my hardware and installing a spacer also without my consent , but its all good if it works right ? Thanks a bunch for your help once again Dave

     
    Old 05-16-2006, 07:36 AM   #21
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    Re: Calling for Shoreline's help

    Dave - I don't know where in PA you live, but would Johns Hopkins be a possibility for you? You say you are already driving 2 and 1/2 hours to see this guy...would it be much further to go to Baltimore? Hopkins is a great place to go for an excellent 2nd or 3rd opinion and they have a spine surgeon there who is just excellent. His name is Dr. David Cohen and he did all of my surgeries. Since it seems like it's almost impossible to get another doc in PA to look at you, maybe it's time to go out-of-state. KathyMac

     
    Old 05-16-2006, 02:23 PM   #22
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    Re: Calling for Shoreline's help

    Hey Kathy, The way Shawley finishes post, I'm no sure if his name is Dave too, but I live in VA closer to the Raleigh, Durham, Chappel hill NC research triangle. Are you talking o me or shawly. Hopkins is a good idea, but there are certainly plenty of great docs all over the US.

    Does it help when you put one of your braces back on shawly? I knew because mylevel of pain just lept increasing after the first surgery and the last surgery they used ground up harvested and cadavor bone, mixed it with BMP and slapped it in like mortar. The idea was it would dry like cement and take growth but he told me to expect some crunching and grinding during the first few month s as it settled and the exces was absorbd. ^ years later and I'm stil crunching and grinding, the squeekingfrom broken hardware is a good indicator too. Because my fusions nerver fused, it wasn't like anything suddenly failed and I knew at that moment. I knew because I didn't improve beyond a certain point and then hardware started breaking which could be seen in Xrays but that took several years. It really wasn't untill the hardware snapped before anyone would admit falure.

    Take care, Dave

     
    Old 05-16-2006, 08:57 PM   #23
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    Re: Calling for Shoreline's help

    Gee Dave! How could you even THINK that I wouldn't know YOU from all the other Dave's in the world??? I think that Shawley ended one of his posts with "Dave" and I was trying to address him by his first name. But I'm sure that I could be mistaken. I was just suggesting to him that if he was having problems with another doctor giving him a second opinion (he stated in his post that after one surgeon has touched you in PA, that nobody else will come near you as a patient) and he wasn't too far out from Baltimore, he would be a good candidate to go to Hopkins. He said he was driving 2 1/2 hours as it is to see his doctor that he's not happy with. I just thought that going out of state would give him a better chance at a second opinion. Hope I'm making sense here. You are right...there are many, many great hospitals and clinics to try - my only experience has been at Hopkins so that's why I suggested it. Take care - KathyMac

     
    Old 05-17-2006, 07:33 AM   #24
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    Re: Calling for Shoreline's help

    Hi Dave , hello KathyMac , no my name isn't Dave , it's Dan . But thats ok , yes I live 2 1/2 hours from Pittsburg and 2 1/2 from Berwick PA Baltimore is probably 3 1/2 to 4 hours away . I am checking with a doc from Penn State to give me an opinion at the moment , But I will keep that doctor's name. Thanks.

    Dave, no I haven't wore that brace since my surgery . For the last 5 days my pain really doesn't bother me that much . Just when I have to walk or stand for a period of time , isn't that wierd ? I have to call the hospital so they can fax me my MRI report so I can read it ,I am very interested on what it has to say before the doctor gets it.

    Dave when my screw was broken in half , one Dr. said it wasn't hurting anything , and the other said it has to come out . My doctor said he had a heck of a time getting that one out . Do you still have broken hardware in you ?

    Dan

     
    Old 05-18-2006, 05:00 AM   #25
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    Re: Calling for Shoreline's help

    Hey Dan, I do have boken hardware in me from the lst set they used to revise the old fuion and also have broken hardware still embedded in the vertabrea from the prior set. They cant always backa a broken screw out or hthey risk the possibility of fracturing the vertabrea.

    When they did the last revision they removed what they could and had to extend the length of the fusion tto a point where they could get 2 solid pedicle screws into the top and bottom vertabrea involved n a fusion. ne screw in a lumbar vertabrea just won't give the support neede to stabalize the spine well or long enough to obtain a solid fusion. It puts too much stress on one half of the vertabrea where the solid screw is and you would be more prone to cause a verticle fracture of the vertabrea that is only supported by one screw.

    If they can get all the screws out and there i no further damage above and below they can do a revision of that one evel, they simply use a larger screw with an expanding head.

    My screws sheareed the heads of at the bone level which alows the hardware to float and cause additional scar tsiisue and wherever he head of the pedicle screw ends up or migrates too can cause some significant problems. If they can't get both screws out of eac vertabnea, they simply lengthen the fusin so that they have a good start and stooping point both secured with solid hardware,then rvise the fusion eith from the back side, the front or both. Unfortunately even when a fusion revision is a success,it doesn't always relieve the pain. A sucesful fusion is one tahat stabalizes the spine, prevents slipage from frnt to bback or side to side,. My back would spontaniously bruise when hardware would shift and I could feel a cutting sensation fr the movement of hardarwe. So the need to revise is contrevaersial due to the outcome of tthe majority of revisions. Even if stabaility can be achied from solid revision after a coupele years of living like that , it's possible that a solid revision won't relieve any of the symptoms your presently experiencing due to the damage done and pain imprinting into the nerve tissue. As bad as things are now, things can get worse. If your able to wrk, your doing bter than sme, and the next surgery may increase your level of pain and leave you disabled for life.

     
    Old 05-18-2006, 05:23 AM   #26
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    Re: Calling for Shoreline's help

    My god Dave you have to be in pain with all the junk floating around in your back. I think I would worry myself sick about them broken screws rubbing and cutting stuff.
    No I don't work at the moment , I was terminated because I cannot lift 65 lbs often.
    I would love to get this all behind me and go on with a NORMAL life again , but anytime I do pretty much anything I pay for it in the end . Yesterday after therapy I grabbed my homelite chain saw and tried to cut up this dead tree thats been lying near my yard since last spring , well last night and so far into this morning I'm paying for it dearly and I didn't even lift. ( only my saw ) My dang leg and foot are on fire and thumping away it was a ruff night of sleep. Ya know when I missed 5 days of therapy I felt ok , as soon as I got on that tread mill the pain's back. I hope the doc figures out what the cause of my pain is , you have to remember a couple months ago I was asking you about settling my comp case ? I was feeling great for a little while ready to take on the world , now I am glad I took your advise and didn't attemp to settle . I hope my wife get's my MRI results faxed to her today , even tho I have no clue what the say or mean . I just don't want to do anymore damage than what I have so far. Thanks for the chat / vent . Your a great help and listener.

    Dan

     
    Old 05-18-2006, 10:50 AM   #27
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    Re: Calling for Shoreline's help

    No MRI report yet , my wife thinks I should have them by tomorrow , It's only been 2 days since my scan . How long does it usually take for them ?

    Thanks Dan

     
    Old 05-18-2006, 01:09 PM   #28
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    Re: Calling for Shoreline's help

    Dave,

    Got my results back just now ,

    Impression:
    1.Area of marrow replacement involving the left posterior ileum presumably reflecting a incidental hemangioma. ( whatever that is )

    2.additional focal fatty rest , hemangioma involving the posterior aspect of the L3 vertebral body.

    3. Transition vertebra with numbering scheme as described above.

    4.Grade 1 spondylolisthesis of L5 on S1. There are postsurgical changes of a posterior laminectomy and spinal fusion. There is mild epidural fibrosis surrounding the thecal sac at this level.

    5. No evidence of disc herniation. No eveidence of significant spinal or foraminal stenosis.

    What does this all mean ? I'm sure my doctor will know more but from this what are they saying ? I'm ok ?
    Thanks for your help..

    Dan

     
    Old 05-19-2006, 07:44 AM   #29
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    Re: Calling for Shoreline's help

    ( Bump this for Shoreline )

     
    Old 05-22-2006, 06:38 AM   #30
    shawley
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    Re: Calling for Shoreline's help

    Quote:
    Originally Posted by shawley
    ( Bump this for Shoreline )
    Shoreline are you around friends , I have read up on hemangioma and it's starting to get clear now where maybe my pain is comming from.

    Whats your thought on all this ? Hope your doing ok , I haven't heard from you in a while.

    Dan

     
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