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    Old 09-13-2010, 12:46 PM   #1
    sandiemas
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    Post Surgery Pain - Help ASAP

    OK, In June I had an ACDF for C6/7 with cadaver bone and hardware then in August I had a Lumbar discectomy on L5/S1. I am due to go back to work tomorrow after seeing my doctor to review my latest MRI. As I have explained to him I am still having severe headache, muscle spasms, and just achey pain in shoulders, neck, mid-back (betweenshoulder blades) and in legs. This is all intensified with genral work around the house, dishes, vacuumming, washing my hair. Ater grocery shopping I am in tears and have to lay down for a couple hours. Thats on a good day. I can imagine after going back to work for a day what it will feel like. I have a 45 min commute driving each way.

    Here is the summary of my MRI report. It looks pretty good to me and I was wondering if anyone can help me understand why I still have such pain?

    Is it all in my head? What should I say to my doctor to make him understand my situation he doesn't listen very well and likes to cut me off mid-sentance.

    This is a foriegn language to me and I do not understand a lot of it. Other than " Normal of apperance". Nothing about me lately feels normal

    Summary:
    There is a normal alignment of the lumbar vertabra. The vertabra are normal of apperance.
    There is a central disc desiccation of the l3-l4-l5 and s1 discs. There is minimal discs space height loss. The conus of the cord at L1 is normal in appearance. There is a slight central bulging of the T11-T12 disc which does not compromise the lower thoracic spainal canal.

    There are posterperative changes of the laminotomy on th left at L5/S1. There is some effacement of the epidural fat in the left lateral and posterior spinal canal at the surgical site. There is aposterior displacement of the s1 root at this level on the left. There is a mild left paracentral protrusion of the disc here. This is similar in pattern but not as prominent in extent to the prior examination. There is some enhancement of the epidural sace in the mid and posterior operative site. The facets are minimally hypertropic here. There is minimal foraminal narrowing laterally.

    The L1-l2, l2-l3, and l3-l4 discs do not protrude. There is no significant facet hypertrophy or foraminal compromise at these levels.

    At L4-L5 there is a mid right lateral bulging of the disc. There is no compromise of the central canal. There is some mild thickening of the igamentum flavum noted. The changes produce some mild to mod
    erate foraminal narrowing on the right and minimal foraminal narrowing on the left side. There is no compromise of the central canal.
    Impression
    1) there is a mild persistent or recurrent left paracentral protrusion of he L5-S1 disc with some psterior displacement of the S1 root. There are changes of laminotomy here with epidural fibrosis in the mid and posteior operative sites.

    cervicale spine

    Findngs: There is a flattening of the cervical lordosis. There are surgical changes consistent with disc space fusion and anterior plating at C6/7 since the last examination. There is some increased signal in focal vertebral body lesion at T2 again demonstrated which is unchanged from the lat study. The forament Magnum is norma. There is no cervical cord lesion demonstrated.

    At the surgical evel of C6/7 the compromise of the central cervical spinal canal secondary to the disc protrusion has been relieved. There is still some thickening of the posterior longitudinal ligament and of the ligamentum flavum at this level approiximating of the cervical cord. There is no direct compresson of the cord. There is mild foraminal narrowing bilaterally which is siilar to the preoperative study.

    The C2/3 disc do not protrude. There is no foraminal compromise at these levels.

    At C4/5 there is a mild left paracentral dis protrusion. This aproximates the cord at but does not impress upon the cord. There is no significant framinal compromise laterally.

    At C5/6 the disc does not protrude and neural foramina remain patent.
    At C7T1 there is no disc protrusion observed.

    The contrast studies do not demonstrate any significant enhancing abnormality. There is a suggestion of some slight enhancement of the T2 vetebral body lession however.

    Impression:
    Postoperative changes of disc space fusion plating anteriorly at C6/7 wiht relief of the stenosis of the stenosis of the cervical spinal canal since the last examnation.

    There is mild persisten narrwing of the spinal canal at C6/7 due to thickening of ligaments. This approximates but does not impress upon the cord.

    There is a mild left paracentral protrusion of the C4/5 disc which is stable in apearance.

    There is a nonspecific lesion in the T2 vertebral body whihc may be an atypical hemangioma.
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    C5-C6 tear/buldge
    C6-C7 ACDF
    T1 - T5 neuroforaminal, lesions, facet arthropathy
    Disectomy L5/S1
    Anxiety
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    Chronic Pain

     
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    Old 09-13-2010, 02:30 PM   #2
    minstrel2
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    Re: Post Surgery Pain - Help ASAP

    I can't speak about your MRI, but since you have had two major surgeries in just the last few months, it is not surprising that you still have some pain, especially after doing all that you report doing. Your body needs to recover. After my surgery, I was so tired after any type of exertion that I had to pace my activity, and still do, even two years later. I can do more now than then, but still tire easily, and when tired, the pain comes.
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    Old 09-13-2010, 03:14 PM   #3
    jennybyc
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    Re: Post Surgery Pain - Help ASAP

    How many times have we all heard this and how many times have I said this same thing....give it time.

    I know you don't feel like you can work and you may find that you have to take more time off but your doc just didn't find a reason to say no just now.

    Spinal surgery takes a long time to heal. The spine has a memory and it remembers being hurt for a long time even after the problem is fixed. On average, it takes a good year for full healing with the procedures you had and 2 years for more major surgeries(I was fused from C3 to T1 and it was 2 years +).

    You may not have physical reasons to not work but yes, you will be tired(anesthesia takes a year to completely clear your system) and you will continue to hurt for a while. Nerves themselves take 8-12 months to heal and even longer. Any cut muscles take 6-8 months to heal. Skin may heal fast but everything under the skin takes much longer and it hurts. And with nerves, they can start hurting to let you know they are back working again.

    I don't think I've talked to anyone around here who didn't find it took a good year+ to stop hurting.

    Sorry, but this is the reality and your doc should have told you this. If you can get more time off, then do so but if you are depending on him to sign for more time off, he might not. He would have to find a reason for it and if he thinks he did a good job on you, then he might not. You'd have an easier time asking your primary about more time off for fatigue due to 2 major surgeries this summer.

    But don't expect the pain to end anytime soon...it will decline and then go up and bounce all over the place but eventually, it will subside. But not this quickly.

    gentle hugs.............Jenny

     
    Old 09-13-2010, 04:00 PM   #4
    sandiemas
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    Re: Post Surgery Pain - Help ASAP

    Thanks for your input. I apreciate all the info I can get. It works as some type of demnted therapy for me. Thanks Again..
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    C5-C6 tear/buldge
    C6-C7 ACDF
    T1 - T5 neuroforaminal, lesions, facet arthropathy
    Disectomy L5/S1
    Anxiety
    PTSD
    Chronic Pain

     
    Old 09-13-2010, 04:05 PM   #5
    sandiemas
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    Re: Post Surgery Pain - Help ASAP

    Jenny B thanks for the honesty in your reply even though it really wasn't what I wanted to hear it does sound like the truth.... I hope you are feeling better and well on your way to recovery.
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    C5-C6 tear/buldge
    C6-C7 ACDF
    T1 - T5 neuroforaminal, lesions, facet arthropathy
    Disectomy L5/S1
    Anxiety
    PTSD
    Chronic Pain

     
    Old 09-14-2010, 02:33 PM   #6
    mikecincy
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    Re: Post Surgery Pain - Help ASAP

    Jenny, You seem to know alot about back pain/surgery and healing time. Here is my situation.

    I have stenosis and steroid shots worked great for 2 years then they didn't last as long. Cat scan showed herniated disc L4-L5.I have/had severe pain in my hip and down leg, and started to get drop foot.

    On 8/12/2010 I had a microdiscectomy. The doctor told my wife that the disc left an imprint on my nerve but believes it will be completely healed.

    I hear all this talk about how long to heal. So it is one month now and on steroid pills and Neurotin. It still feels like the same pain down my leg especially in my hip/butt.

    Should I have no relief after a month? I try to walk but still have drop foot.

    Your knowledge is welcome.

    Thank you



    Quote:
    Originally Posted by jennybyc View Post
    How many times have we all heard this and how many times have I said this same thing....give it time.

    I know you don't feel like you can work and you may find that you have to take more time off but your doc just didn't find a reason to say no just now.

    Spinal surgery takes a long time to heal. The spine has a memory and it remembers being hurt for a long time even after the problem is fixed. On average, it takes a good year for full healing with the procedures you had and 2 years for more major surgeries(I was fused from C3 to T1 and it was 2 years +).

    You may not have physical reasons to not work but yes, you will be tired(anesthesia takes a year to completely clear your system) and you will continue to hurt for a while. Nerves themselves take 8-12 months to heal and even longer. Any cut muscles take 6-8 months to heal. Skin may heal fast but everything under the skin takes much longer and it hurts. And with nerves, they can start hurting to let you know they are back working again.

    I don't think I've talked to anyone around here who didn't find it took a good year+ to stop hurting.

    Sorry, but this is the reality and your doc should have told you this. If you can get more time off, then do so but if you are depending on him to sign for more time off, he might not. He would have to find a reason for it and if he thinks he did a good job on you, then he might not. You'd have an easier time asking your primary about more time off for fatigue due to 2 major surgeries this summer.

    But don't expect the pain to end anytime soon...it will decline and then go up and bounce all over the place but eventually, it will subside. But not this quickly.

    gentle hugs.............Jenny

     
    Old 09-14-2010, 03:10 PM   #7
    jennybyc
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    Re: Post Surgery Pain - Help ASAP

    Some realities with spinal surgery!

    It will take about a year for things to shake out and you know what will heal and what won't(or longer).

    Spine surgery is not done to relieve pain but to stop further damage and stop the development of paralysis.

    Pain may actually increase as you heal as nerves that are repairing themselves will often let you know they are back and working with a lot of pain...like saying hello in pain decibels. It will get better with time.

    Injuries to spinal nerves may never get any better but spinal cord injuries often do. Stats on getting rid of pain....about 30% success rate. Stats on getting rid of numbness....about 70% success rate.

    # 1 thing I tell everyone...you have to give it time. And no, at one month post op you are just starting to heal and you need a lot more time to know if it will go away. And it may not. The injury may be permanent. But it beats paralysis.

    I broke my neck 3 months after major neck surgery and came out of surgery paralyzed on the left with major muscle dysfunction all over my body. The pain was intense for a good 6 months. At 8-9 months I started to get feeling and movement back on the left and the other muscles started to work better. At 18 months post-op, I was finally getting some strength back on the left. At 30 months post-op, I finally did the last of the PT working on regaining balance.

    Within a month of getting my balance back, I started to lose the left arm again. The tendons have gone lax and I dislocate the joints regularly. It is losing sensation slowly. But the strength has help up. At 3 1/2 years post-op, I am now dragging my left leg if I'm not careful. I keep a cane in my car for those days that I am tired and likely to drag it. But my neurologist just looks at me like I'm amazing. I was paralyzed. I may not be as good as I was at 30 months but I am not paralyzed.....that is the bottom line.

    I will be 4 years post-op this January. I still get pain and headaches and muscle spasms. I will for life but I can walk and even run, although clumsily. I'm not in a wheelchair. And the pain level has lessened slowly but surely and I hope the same will happen for the spasms and headaches. What pain I do have is forever because the nerves were too damaged to recover. I take no pain meds...I don't want to live a life drugged up so I've learned to cope.

    Give it time. If you are going to heal you will. Try taking a Vitamin B supplement as B's help nerves heal.......are necessary for nerves to heal. If you are offered PT, do it. The muscles need to be kept supple for when the nerves heal. And then wait. How many years do you think it took to put a dent in that nerve? Many....so give it at least a year or 2 for it to try to heal.

    It used to be thought that nerve cells never healed...they couldn't. But they do but so slowly. Give it time.

    hugs..............Jenny

     
    Old 04-12-2011, 05:47 PM   #8
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    Re: Post Surgery Pain - Help ASAP

    Quote:
    Originally Posted by sandiemas View Post
    OK, In June I had an ACDF for C6/7 with cadaver bone and hardware then in August I had a Lumbar discectomy on L5/S1. I am due to go back to work tomorrow after seeing my doctor to review my latest MRI. As I have explained to him I am still having severe headache, muscle spasms, and just achey pain in shoulders, neck, mid-back (betweenshoulder blades) and in legs. This is all intensified with genral work around the house, dishes, vacuumming, washing my hair. Ater grocery shopping I am in tears and have to lay down for a couple hours. Thats on a good day. I can imagine after going back to work for a day what it will feel like. I have a 45 min commute driving each way.

    Here is the summary of my MRI report. It looks pretty good to me and I was wondering if anyone can help me understand why I still have such pain?

    Is it all in my head? What should I say to my doctor to make him understand my situation he doesn't listen very well and likes to cut me off mid-sentance.

    This is a foriegn language to me and I do not understand a lot of it. Other than " Normal of apperance". Nothing about me lately feels normal

    Summary:
    There is a normal alignment of the lumbar vertabra. The vertabra are normal of apperance.
    There is a central disc desiccation of the l3-l4-l5 and s1 discs. There is minimal discs space height loss. The conus of the cord at L1 is normal in appearance. There is a slight central bulging of the T11-T12 disc which does not compromise the lower thoracic spainal canal.

    There are posterperative changes of the laminotomy on th left at L5/S1. There is some effacement of the epidural fat in the left lateral and posterior spinal canal at the surgical site. There is aposterior displacement of the s1 root at this level on the left. There is a mild left paracentral protrusion of the disc here. This is similar in pattern but not as prominent in extent to the prior examination. There is some enhancement of the epidural sace in the mid and posterior operative site. The facets are minimally hypertropic here. There is minimal foraminal narrowing laterally.

    The L1-l2, l2-l3, and l3-l4 discs do not protrude. There is no significant facet hypertrophy or foraminal compromise at these levels.

    At L4-L5 there is a mid right lateral bulging of the disc. There is no compromise of the central canal. There is some mild thickening of the igamentum flavum noted. The changes produce some mild to mod
    erate foraminal narrowing on the right and minimal foraminal narrowing on the left side. There is no compromise of the central canal.
    Impression
    1) there is a mild persistent or recurrent left paracentral protrusion of he L5-S1 disc with some psterior displacement of the S1 root. There are changes of laminotomy here with epidural fibrosis in the mid and posteior operative sites.

    cervicale spine

    Findngs: There is a flattening of the cervical lordosis. There are surgical changes consistent with disc space fusion and anterior plating at C6/7 since the last examination. There is some increased signal in focal vertebral body lesion at T2 again demonstrated which is unchanged from the lat study. The forament Magnum is norma. There is no cervical cord lesion demonstrated.

    At the surgical evel of C6/7 the compromise of the central cervical spinal canal secondary to the disc protrusion has been relieved. There is still some thickening of the posterior longitudinal ligament and of the ligamentum flavum at this level approiximating of the cervical cord. There is no direct compresson of the cord. There is mild foraminal narrowing bilaterally which is siilar to the preoperative study.

    The C2/3 disc do not protrude. There is no foraminal compromise at these levels.

    At C4/5 there is a mild left paracentral dis protrusion. This aproximates the cord at but does not impress upon the cord. There is no significant framinal compromise laterally.

    At C5/6 the disc does not protrude and neural foramina remain patent.
    At C7T1 there is no disc protrusion observed.

    The contrast studies do not demonstrate any significant enhancing abnormality. There is a suggestion of some slight enhancement of the T2 vetebral body lession however.

    Impression:
    Postoperative changes of disc space fusion plating anteriorly at C6/7 wiht relief of the stenosis of the stenosis of the cervical spinal canal since the last examnation.

    There is mild persisten narrwing of the spinal canal at C6/7 due to thickening of ligaments. This approximates but does not impress upon the cord.

    There is a mild left paracentral protrusion of the C4/5 disc which is stable in apearance.

    There is a nonspecific lesion in the T2 vertebral body whihc may be an atypical hemangioma.
    It is NOT all in your head! I am experiencing the same kind of pain, though at this stage I've just had my cervical 6/7 replaced. I am still getting tingling in my right hand, so the surgery didn't resolve that. Also, NEW pain between my shoulder blades and hideous headaches.

    I had my op about 6 weeks ago. My neurosurgeon is arrogant and doesn't give any advice. I'm not sure how long this will go on. When will I be pain free? Can anyone who's had this operation give me an idea?

     
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    Old 04-17-2011, 05:21 PM   #9
    yakkwak
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    Re: Post Surgery Pain - Help ASAP

    Hi, Take time to take care of yourself and make certain that your anxiety d/o is well cared for during this fragile recovery time. Any loss of ground gained in that area can exacerbate existing pain issues. There is evidence to suggest that this d/o can interfere with relaxation of muscles and this can contribute to your overall pain level. We have one body apiece, and when we have multiple issues, they are all related and affect each other! Further, if you feel there is a chance that the trauma of surgery may be potentially triggering any issues related to past psychological trauma, seek help!
    Blessings & hugs

     
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    sandiemas (04-26-2011)
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