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Dr. Whitworth, I feel like jumping! Guidance please?

Dr. Whitworth, I feel like jumping! Guidance please?

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Posted by Fay on April 17, 2000 at 15:07:50:

I am a 38, professional female, married, childless and 30 months post-op laminectomy at S1. History of glaucoma and moderate psoriasis that worsens with NSAID use. Severe leg symptoms, not back pain, sent me to surgery. Post op developed severe bi-lateral low back pain in addition to lingering radicular leg pain, spasm and motor loss. I did PT for 1 year. Insurer felt that condition was permanent and PT no longer theraputic and it was stopped. Neurosurgeon felt he'd done what he could but thought PT should be continued. (Please note: at no time was I released for return to work and have since received favorable determinations from social security and LTD insurers. Additionally, there is no pending litigation or economic gain sought or expected.)

Increasing pain levels sent me to neurologist who diagnosed epidural fibrosis without further imaging and prescribed Neurontin. Neurontin helped significantly with shocking/burning but does not eliminate it and does nothing for back pain. Additionally, side effects have been awful (dizziness, headache, slurred speech, clumsiness, dental problems and weight gain.)

9 months ago started to experience joint pain (hips, ankles, knees) and stiffness (no swelling). Started with accupuncture. Moderate relief from worsening leg spasms but little else. Psoriatic arthritis suspected. Neurologist doubted it. Pain increasing. BEGGED neuro to order MRI. He refused. Internist dumbfounded and ordered it himself and referred to rheumatologist who ruled out psoriatic arthritis.

MRI shows 1)significant scarring on S1 nerve root extending into thecal sac on left. 2)severe narrowing of disc at S1, 3) significant loss of lordotic curve, 4)significant degenerative disc disease at L4-L5 and L5-S1, 5)diffuse disc bulging from L3 thru S1 and finally, small disc herniation at L4-L5. Neuro said: "that's not too bad."

I feel like screaming! I have not slept more that 5 hours in over 2 years. Sitting is a horror. Laying flat not much better. I am effectively housebound due to both pain and side effects of neurontin. OB/GYN does not think pregnancy is a good idea due to condition and neurontin. Rheumatologist thinks ESI a good option. I got clearance for ESI from opthamologist & dermatologist. Neurologist thinks it's overkill. He thinks magnetic impulse therapy better route.

I am not a doctor but I think that maybe, just maybe, old fashioned painkillers may be justified. I have no history of substance abuse and I suspect that I am grossly undermedicated. I wondered why the insurance company did not challenge my disability claim! (I never received any diagnosis from their IME). My internist is friendly with the neuro and won't step on his field of expertise or offer an opinion. I wonder if this is a surgically correctible problem?

Any suggestions? Anybody? Please?

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