I had surgery 11 years ago, on L5-4, herniated disks!!
Anyway, in November 2012, I started getting the numbness and pain, and my back would just LOCK up, so after 2 MR's and 2 CT scans, my neurosurgeon want a to operate and part of that is a fusion.
Findings on last CT Scan: the vertebral body heights are maintained. 0.7 c. L-5 -S-1 degenerative anterolisthesis as well as 0.4 cm L-2 - L-3 retrolisthesis is noted. There is moderate L-5 - S-1 and severe L-4 -5 disk degeneration.
L-1 - 2, no canal or foraminal stenosis.
L-2- 3, annulus bulge and facet degeneration results in mild-moderate canal and bilateral foraminal stenosis not significantly changed.
L-3 - 4 annulus bulge with extension into both neural foraminal and facet degeneration results in mild-moderate canal and bilateral foraminal stenosis unchanged.
L4-5, bilateral hemilaminectomy defects are noted. Annulus bulge superimposed on marginal osteophyte with extension into both neural foraminal, loss of disc height and facet degrneration results in moderate bilateral foraminal stenosis. There is mild effacement of the thecal sac without significant canal stenosis.
L-5 - S1, anterolisthesis with exposed annulus bulge extending into both nerural foraminal, loss of disk height and facet degeneration results in moderate bilateral foraminal stenosis. The central canal is patent.
Multilevel canal and foraminal stenosis not significantly change since the prior study.
Degenerative L-5 - S-1 anterolisthesis and L-2 - 3
I am currently taking;
300 MG GABAPENTIN 3x's a day
2 MG HYDROmorphone 2 every 4 to 6 hrs
5 MG DIAZEPAM 3 x's a day
Well, since there has not been much change since the last study, consult your doctor about change in pain medication. At times using a round the clock pain relief patch helps. Along with this oral medication is given to control spikes of pain. Physiotherapy, hydrotherapy and yoga are other treatment modalities which can be simultaneously tried. If all these options do not bring pain relief, then maybe you will get some benefit from surgery. Please take a second opinion from a neuro-surgeon in your area or an orthopedic surgeon specializing in spinal surgeries. Take care!
The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.
Unlike the suggestion from the "Dr." on here....I can't imagine someone being moved from only taking Hydrocodone which is low on the totem pole of medications all the way to something like the Fentanyl patch which is one of the strongest medications out there. It is ONLY for opiate tolerant paitents...
You have plenty of other medication choices to move to and see if this helps. Oxycodone is the next medication up or even Oxycontin in a low dosage like 10mg twice a day as this would be a bit higher strength than what you are taking now but would give you more steady pain relief throughout the day. Oxycontin is just plain Oxycodone in a long acting formula.
You are also on a very low dosage of the Gabapentin. It can be dosed all the way up to 3600mg a day. Most people get relief from about 1400mg to the 2600mg range....So not sure how long you have been on this but usually a patient once they are used to the side effects and they have diminshed is moved up to get better nerve pain relief.
I do agree with getting at least 2 other opinions from Board Certified Neurosurgeons (make sure they are Fellowship trained as well) to see if surgery is really needed. Things have advanced in the last 11 years so it may be something that can help stabalize your spine.
I've had 3 fusions over the last 11 years.....And they were done on an immediate basis after seeing the MRI......
I would also suggest talking to your Dr. about being on an actual muscle relaxer....Diazepam (Valium) is really an anti-anxiety medication and used "off label" to relax muscles. Many Drs. are now going to stop prescribing it for this usage as it's a highly abused drug these days (NOT saying this is you at all...just making a general statement)...
Actual muscle relaxers work much better and target the spasms...These are either Flexeril or Amrix, Robaxin, Skelaxin, Baclofen, or Zanaflex.
I'm not sure who is prescribing your meds now, but if it's not an actual Pain Mgmt. Dr...then I would suggest making an appt. with one to go over your case and see what type of comprehensive treatment plan they can provide for you. There are many modalities to use to help chronic pain if surgery is not feasible right now...
There is daily exercise, physical therapy, traction, TENS unit, injections, nerve ablation, acupuncture, massage, ice, heat, NSAID patches, lidocaine patches, steroids, biofeedback, aqua therapy, etc.....
I think Mike is taking 2mg hydromorphone which is generic Dilaudid. But I agree with everything else WeatherGirl said, also a benzodiazapine is not a good choice for a muscle relaxer, in my opinion. If its spasms that you get then I think Baclofen would be a better choice because its more of an anti-spasmatic more than just a muscle relaxer. I would think Flexerill or skelaxin etc. would be better for muscle tightness and soreness. Best of luck to you.
Dag nabbit...I hate not being able to edit! LOL...I meant Hydromorphone but typed too fast for my brain....:) Thanks for catching this! But yes...still other choices of meds before ever going to the Fenantyl patch...
Thank you all for your advice!! I got apProvale today for the surgery!! So Monday I have to call and schedual appointment for the surgery!!!
Thank you again for your heartfelt advice!!!
Thanks you, Mike
Well here is the latest update.. 2/13/2013
As of today I haven't had the back surgery that I posted about earlier.
My insurance DENIED MY SURGERY. They said that I didn't need the surgery!!!!!
Well I wish they had my back problems so that they knew what I am going through, I have lost my job because I worked in construction so my company won't let me go back to work because of the Potential liability!!
Thank you for your advice,
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