Discussions that mention acetaminophen

Back Problems board


Hi Peaches & Hubby, :wave:

I'm so sorry for the delay, I promised to be back, and here I am :)

You asked the following questions, I will do my best to answer you both.

He wanted to know if your hips ache? He noticed this after his surgery.
**** No, actually my hips have been fine since surgery, although they bother me terribly before the surgery.
Did he possibly have a hip grafting done during his first surgery ? Most hip related complaints after surgery are usually related to the hip grafting. My pelvic bone was used for grafting. If they did a hip graft, I have heard that area sometimes takes a very long time to heal.

Also, what exactly is a discogram? Is it painful like the nerve root blocks? No one has ever mentioned such a diagnostic test.
**** I will post a discogram explanation for you at the end of this posting, if you do a search here listing the past discogram discussions, you will find out alot more info as well. I think it's the best test available to determine disc trouble.

Do you have foot drop? He says when he walks it feels as though he has a flipper on his foot, like its dragging?
**** No, I don't have this problem, but that has also been discussed in the past, and I believe this is nerve related, hopefully more people will see this posting and jump in with some info now that it has been moved back to the top of the list.
I'm behind on postings, so I try to read the older ones first, from where I last left off.

One more thing - this one is embarassing, ok here goes do you feel like you always have to have a bowel movement? He says that he never feels 'quite' done. Now i know with my 2 pregnancies i had sciatica and i always felt pressure at my tailbone (that's where he feels the most pain) so maybe it has something to do with that??????????
**** I would assume this could also be disc related, or possibly nerve related.
I don't have this problem either.
I'm not a doctor, and have no knowledge of this problem other than from what I have read, so please make sure this situation is discussed with his doctor to get proper diagnosis.
You can do some research on what is called Cauda Equina Syndrome, here is a little tid bit:

What is Cauda Equina Syndrome?

Cauda Equina Syndrome is usually due to a massive disc herniation, most commonly seen at the lowest discs on the spinal cord, and a related compression of the thecal sac (the surrounding cover of the nerve roots and spinal cord). Cauda Equina Syndrome can also stem from vertebral collapse due to tumor, infection or trauma (force from an accident or fall).

Individuals with Cauda Equina Syndrome will experience back pain, motor weakness in the lower extremities, sensory deficits, saddle anesthesia (unable to feel anything in the area that would sit on a saddle: the inner thighs, perineum, sacrum), urinary retention, and bowel incontinence.

Treatment

For patients with these symptoms, an MRI or myelogram with or without a CAT scan should be obtained immediately. If a cause for the compression is found and is amenable to treatment by surgery, the patient should be referred immediately for surgical decompression. The surgical decompression should be done on an emergent basis. As previously stated, the best results for Cauda Equina Syndrome have been found in patients who received prompt surgical intervention.

Here is the discogram tid bit: Mine was very painful, but again, I have such a strong belief in this procedure, that I'd do it again in a heart beat.

Technique
While different discographers may vary the procedure slightly, the following provides an overview of modern technique for a lumbar discogram.

History and Physical Exam
A nurse or other healthcare professional conducts the initial interview. All of your questions and concerns should be addressed and answered. This is the time to relate any and all horror stories you may have heard from medical (and non-medical) experts. Despite what you’ve been told, the discogram is not designed to create agony.

Next, the discographer will talk with you to review the relevant anatomy and discuss the procedure in much greater detail. You now have a second chance to ask questions or decide whether or not to proceed.

Initial preparation
If you agree to allow the discographer to perform this exam, an intravenous line is started just in case intra-procedural medications become necessary. Usually, sedation is avoided so as not to interfere with any reactions or sensations you may experience.

Next, you are placed on a specialized table around which a fluoroscopic (x-ray) unit is positioned. Your back is then marked with an ink pen over the disc spaces that will ultimately be examined. Then your back is thoroughly cleansed and sterile drapes are applied. The fluoroscope will also be sterilely draped and the discographer will be in a sterile surgical gown.

Administration of local anesthesia
The goal is to anesthetize a core of tissue that extends from your skin to the disc surface. When these tissues are numbed a guide needle is directed towards the disc and will just touch the outer surface of the annulus (the outer margin of the disc).

Through this guide needle a much smaller disc needle is advanced towards and eventually into the center of the disc. This process should not be painful, but sometimes may be.

The procedure usually takes less than an hour to perform. You’ll have soreness from the needle punctures that lasts several days. You may use acetaminophen, ibuprofen or apply an ice pack for a few minutes to ease the soreness. Some physicians prescribe short term narcotic pain medications for use after the procedure.

Pressurizing the discs - the diagnostic portion of the procedure
After all of the needles are placed, the discs are "pressurized" one at a time. Pressurization consists of injecting small amounts of a sterile liquid (usually contrast material [x-ray dye]) into the center of the disc.

This is the most important part of the study and you must concentrate on what you are feeling. There are essentially three choices:

1) You feel nothing
2) You feel pressure
3) You feel pain
If you feel pain from the injection, the pain is either:

Familiar pain, which translates into "ouch, that’s my pain!"
Unfamiliar pain, which belongs to someone else or translates into "ouch, I’ve never felt that pain before."
After each level is pressurized, pictures are taken with the fluoroscopic unit and the needles are removed. Usually, a post-discogram CT is obtained to document the internal architecture of the disc. And that’s it!

The procedure usually takes less than an hour to perform. You’ll have soreness from the needle punctures that lasts several days. You may use acetaminophen, ibuprofen or apply an ice pack for a few minutes to ease the soreness.

Possible risks and complications
As with any other invasive test, there are associated risks and possible complications.

The most feared complication is a disc space infection, which can be very difficult to treat. Fortunately, by using very strict sterile techniques this is a very uncommon complication.
There are extremely remote possibilities of nerve root injury
Spinal headache is also a remote risk
With a skilled and experienced discographer who uses modern discography techniques, all of these risks are very rare.

In summary, a discogram is a preoperative study designed to determine if an intervertebral disc is a pain generator. The initial needle placement need not be painful. If pressurization of a disc causes a familiar pain, then surgical obliteration (fusion) of the pain generator(s) may afford significant pain relief.

I'm so sorry that your husband is having all of these issues to deal with, living with back pain is horrible enough, but to have these added symptoms is very difficult to deal with.

Have you looked into obtaining a W/C attorney yet ?

I'm so very sorry :( that your husband is going through all of this, I think once you get a good W/C attorney, they should be able to get these doctors to address his concerns.

I feel so bad that I wasn't much help with these questions, but others will be along soon to chime in, that is what is so nice about this forum, the people here are the best.

I hope that you both have a very peaceful evening, and I pray that your hubby can find relief very soon.

I'm still here for you if I can be of any further help.
It just might take me a little time to respond back, but I promise that I will.

Be Well,
Baxter [img]http://www.healthboards.com/ubb/heart.gif[/img]

------------------
Two level laminectomy fusion L5-S1 & L2-3 done on 12/6/02.
I regret the day that I agreed to have this surgery.
Fifteen inch scar from the very top of butt crack (sorry), to the bra line.
BAK cages, rods & screws.(Titanium)
My pelvic bone was used for grafting.
Praying that the other two discs in between, won't have to be fused later, as I was told it was a possibility, due to the other two discs in between, not being in that great of shape.
Doc didn't want to fuse four levels, unless it is really necessary.
I would hate to repeat the surgery, as the recovery period, is so very painful.
I also have a free fragment in my T11-12 area, that I'm still refusing surgery for, at this point in time.
That surgery is way too dangerous for me to consider, until if affects my being able to walk.

[This message has been edited by BAXTER (edited 06-04-2003).]

[This message has been edited by BAXTER (edited 06-04-2003).]