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Post Surgery Pain - Please 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 blads) 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.
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 hich 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 laeral 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 moderate 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.
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 hich 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 laeral 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 moderate 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.
Thank you for your comments. You addressed a lot of my concerns. I feel like such a let down some times. But it is true I had two major surgeries back to back. The lumbar was nothing I still have leg pain and muscle spasms but the recovery was nothing compaired to the ACDF. I went through times of not being able to walk to severe migraines that ended me up in the hospital. My surgeon got so mad at me he finally offered me Xanax if I'd stay out of the Emergency room. I thought this was horrid and refused of course. What would you do if your head felt like it was going to exploid and had uncontrolable vomiting for days? Go to the hospital. Same with the legs if I am paralized all of a sudden I am going to get it checked out. Turns out both were just part of the nerves coming back to life and the healing process. But man it would have been nice if he explained that ahead of time!!!
Yes, I am 3 months out and I just started Physical Therapy. My first time I was in tears due to muscle spasms my range of motion is less than 40% on almost all the areas he tested. I take a soma now before I go and it has been helping. As far as meds I am on Vicodan, soma, and cymbalta for all over nerve pain. The meds work on taking me from an 8/9 to a 3/4 but do not kill the pain completely at least I know I am still alive:) I should probably be doing more but I just havent been able to.
How was your ACDF recovery? Any suggestion to speed this along? Did you have major issues with Muscle Spasms? They actually showed up on my MRI last week as big bumps in my muscles along the shoulders. Trippy.
Yes, I am 3 months out and I just started Physical Therapy. My first time I was in tears due to muscle spasms my range of motion is less than 40% on almost all the areas he tested. I take a soma now before I go and it has been helping. As far as meds I am on Vicodan, soma, and cymbalta for all over nerve pain. The meds work on taking me from an 8/9 to a 3/4 but do not kill the pain completely at least I know I am still alive:) I should probably be doing more but I just havent been able to.
How was your ACDF recovery? Any suggestion to speed this along? Did you have major issues with Muscle Spasms? They actually showed up on my MRI last week as big bumps in my muscles along the shoulders. Trippy.
I had C6-7 done a few years ago, and L4-5 fused several years ago. Recovering from both those surgeries at the same time must really be hard. I agree with the above post that you might have some minor issues at L4-5, but as far as your Cervical, your right, it looks okay.
I have to tell you, your probably still recovering from both these procedures. I guess recovery from a Lumbar discectomy is a little easier than recovering from a Lumbar fusion, it took me 6 months to where I felt half way decent and almost a year to fully recover. And my ACDF recovery was really hard, you're only at about 3-1/2 months out on that right? Did you go to Physical Therapy? I didn't start until 3 months, because I was in too much pain, and I went for 3-4 months. What are you taking for meds?
The pain you're experiencing is common for a certain number of us that have this procedure, the reason I say a "certain number" is because some people are better in 3-4 weeks and people like me aren't, I don't know why.
The headaches, muscles spasms and the scapular pain are just something that goes along with recovering from this. And it doesn't necessarily mean that something is seriously wrong. When they go in there and mess around with your nerves, it very traumatic on your system and it takes a long time to recover. Hopefully your Doctor can understand this.You'll get better, you just need more time.
Take Care
I have to tell you, your probably still recovering from both these procedures. I guess recovery from a Lumbar discectomy is a little easier than recovering from a Lumbar fusion, it took me 6 months to where I felt half way decent and almost a year to fully recover. And my ACDF recovery was really hard, you're only at about 3-1/2 months out on that right? Did you go to Physical Therapy? I didn't start until 3 months, because I was in too much pain, and I went for 3-4 months. What are you taking for meds?
The pain you're experiencing is common for a certain number of us that have this procedure, the reason I say a "certain number" is because some people are better in 3-4 weeks and people like me aren't, I don't know why.
The headaches, muscles spasms and the scapular pain are just something that goes along with recovering from this. And it doesn't necessarily mean that something is seriously wrong. When they go in there and mess around with your nerves, it very traumatic on your system and it takes a long time to recover. Hopefully your Doctor can understand this.You'll get better, you just need more time.
Take Care
Thanks for the info, I don't think I am ready to go out and play baseball yet but I will take your advice to heart. I agree that the best way to make things better is to get out and move, get sore, let you body adjust/recoop and get back on the saddle. My problem is that I work for the state if I go back to work and can't handle it I have use up all the sick and vacation time that I have saved up for 5 years and would be out on the street before disability kicked in that that's if I qualified. If I stay out now in November it turns to long term disability and I have a better chance. It is a sad situation and I feel horrible but that is how they have made it for us in the US. You spend your whole life working hard and one little thing can send you into hysteria.... As you can see I have a little anxiety about the whole thing as well. I have been a foster parent for years and had to stop that because it wasn't fair to the kids that I am not able to get out to the park, ball games, and such with them, now my employement may suffer I have been out since April 2010.... Ugggh what an ugly situation.
Good luck with your neurosurgeon and with you back I hope it all turns out for you.:)
Good luck with your neurosurgeon and with you back I hope it all turns out for you.:)
That information is very foreign to me, but it seems as if there 'could; be an issue with your L4-L5 disc.
5 years ago, I had a cage put into my L4-L5 because of the disc being shot and also a cracked vertebrae. I mention this because I have a 'little' knowledge in this area due to endless hours of research and talking with many doctors. Remember, I am No doctor, so don't take my words and put them into stone.
Ok, There are some issues regarding your L4-L5, but your doctor may see this as no problem. My neurosurgeon said that, "everyone is different, and one person may feel pain with a blown disc, while another person never has a clue that their disc is done for."
My personal opinion would be to get a referral from your primary physician, and get a second and even third opinion if necessary. The more eyes the better when it comes down to you still having pain and supposed to go back to work tomorrow. Go to work, see how the day goes, and the following week or two. I had Much pain after my surgery, for about 6 months to be precise, but I ended up going out to play baseball with my boy because I couldn't stand still having the pain and being couped up in my house dealing with situational depression that stemmed from the previously mentioned pain I had. Well, my wife freaked out as we left for the field- lol, but 3-4 days after the pain subsided from actually moving muscles that had not been used for a Long time, I was actually pain free.
But now it is 5 years later and I am having Extreme pain due to another disc I am sure. I am heading to see a neurosurgeon in a Major hospital when my family doctor's nurse calls me back. Ok, my back can't sit anymore, so Good Luck with your situation, and second opinions are never a bad thing. This could eliminate any possible 'mental conflicts' that a post surgery may cause, or your pain is real and further action is needed.
5 years ago, I had a cage put into my L4-L5 because of the disc being shot and also a cracked vertebrae. I mention this because I have a 'little' knowledge in this area due to endless hours of research and talking with many doctors. Remember, I am No doctor, so don't take my words and put them into stone.
Ok, There are some issues regarding your L4-L5, but your doctor may see this as no problem. My neurosurgeon said that, "everyone is different, and one person may feel pain with a blown disc, while another person never has a clue that their disc is done for."
My personal opinion would be to get a referral from your primary physician, and get a second and even third opinion if necessary. The more eyes the better when it comes down to you still having pain and supposed to go back to work tomorrow. Go to work, see how the day goes, and the following week or two. I had Much pain after my surgery, for about 6 months to be precise, but I ended up going out to play baseball with my boy because I couldn't stand still having the pain and being couped up in my house dealing with situational depression that stemmed from the previously mentioned pain I had. Well, my wife freaked out as we left for the field- lol, but 3-4 days after the pain subsided from actually moving muscles that had not been used for a Long time, I was actually pain free.
But now it is 5 years later and I am having Extreme pain due to another disc I am sure. I am heading to see a neurosurgeon in a Major hospital when my family doctor's nurse calls me back. Ok, my back can't sit anymore, so Good Luck with your situation, and second opinions are never a bad thing. This could eliminate any possible 'mental conflicts' that a post surgery may cause, or your pain is real and further action is needed.
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I was taking similar meds at that point too, and as far as doing things, you do what you can.You're strength will come back. Your talking about dishes, vacuuming, and general house work and grocery shopping. I couldn't do any of those things at that point, well I might have been able to do one of them. The 1st time I went back to the store, I was amazed at how much effort and walking was involved, it was overwhelming. If there was something I needed that was too far away, I just didn't get, I didn't have the strength.
My recovery was kind of long, I don't want to discourage you. There's not much you can do to speed it up, you just have to be patient and therapy will help. I had a lot of muscle spasms, but I wouldn't say I had major issues with them. More the headaches (they'll start to lighten up) neck pain (therapy helped this) and the scapular pain. Walking helps, but it sounds like you do enough of that already, don't push yourself too hard.
You're going to have good days and bad ones, pretty soon they'll be a lot more good ones. Going through something like this really makes us see how we take our good health for granted.
Take Care