Lumbar Spinal fusion L5 S1

[floodmaster76]

I am 34 years old now. I had an accident at work 2 years ago(07-07-09) when a rock retaining wall gave way and I fell 15 feet or so. I landed on a rock on a 40% decline. When I fell I twisted and landed on my back/buttocks, elbows, hands and on my right leg. I went to the emergency room and was referred to an optho. spine surgeon. Months of seeing him and being on pain meds went by before workers comp approved an MRI and it showed the I had a tear in my spine/disk at the L5S1 level and it was so close to the nerve on the right side my Doc said that haxd to be getting pitched. Therapy went on for several months and I was still in a lot of pain but it kept getting worse. I couldn't bend down to even tie my shoes pain would shoot down my legs all the way to my foot it was turning into a nightmare. I got approval to try the injections and they didn't work for more then 3 or 4 days. The Doc put in to try to get approval on a micro disceptomy(sorry for the typo) to remove part of the disk to make room for the nerve. Well that finally got approved and that was done 07-19-2010. The surgery was a little painful and took quite a while to heal but the only problem was that the original pain never went away. So serveral months of more therapy that too me til 1-1-2011. Nothing helped and pain seemed to be getting even worse yet. More injections got approved and once again they didn't work. My Doc said the only thing left to try is a lumbar spinal fusion at L5 S1 level. Well it took til May 2011 to get approval on this. I had to try everything cause I couldn't go on living like this. I get a second opinion by a Neuro surgeon who is supposed to be one of the best in the country. He agreed that there would be about a 60-70% chance that I would get relief from this Lumbar Spinal Fusion Surgery. He would be partnering up with my Orthopedic Spine Surgeon and they would be doing this together to make sure everythings goes good. I had the Lumbar spinal fusion at L5 S1 level done on July 15, 2011 which has now been just over 2 weeks. I am in an extreme amount of pain it hurts to walk, sit, stand, and lay down. I can't sleep for more then a hour at a time. I have pain obviously in m lower back that wraps around my stomach, pain down my legs, I am on oxycontin 20 mg 2 every 12 hours, dilaudid 4 mg 2 tablets every 4-6 hours, Valium 10 mg every 6 hours and can barely stand the pain with all of that. I just got my 30+ staples out just the other day and I feel a really bad pulling feeling in my back all the time. I don't know if this is part of the healing process but I am in pain that I can barely handle and I thought I had a high pain tolarance. On top of all of that I am having very bad pain in my shoulders and elbows and don't know why, between the shoulders and back pain I can't sleep for more then an hour at a time. I think I am going crazy, I can't do anything, can't sleep and just lay here in pain. I hope this gets better but it seems to be getting worse.  I know its early in the recovery process but I don't understand why my shoulders and elbows are hurting so bad and what does this have to do with a Lumbar spinal surgery and anyone have any ideas why this is happening?

[floodmaster76]

Thank you very much for your response and suggustions. They are helpful and they help me better understand my Doc. Maybe I was just being too sensetive and maybe not looking from his point of view. The only thing I understand is how much pain I am having and I deal with it 24/7 and I think he don't realize what i am going through but he must know because I am sure he deals with it on a daily basis. Thanks again for your response. Tony

[S. Kaul, MD]

Hey Tony!

I understand how you must be feeling, but doctors generally have to be very cautious with prescribing pain medication; since these have a high abuse potential. Most people do not understand the risks of overusing the medications and I believe your doctor was just trying to be cautious and did not actually mean to be rude. Anyhow, the decision of a brace is decided on individual basis, while physiotherapy is required in most cases. I would suggest discussing the possibility and the pain symptoms with your doctor in detail at your next appointment. Hopefully your doctor would b able to work something out for you. Meanwhile I would advise limiting movements around spine like bending and twisting/ turning etc. Aside the prescribed medication, you may try using ice-packs around the region for a symptomatic relief.
Hope this is helpful.

Take care!

[floodmaster76]

The day before yesterday, making things even worse I called my Doctor cause I am getting a little low on my pain meds and I had to leave a message.(If I run out over the weekend I'm in trouble so I figured I would take care of it way before then. I have enough meds to get me until Saturday) Just to kind you give you the inside on my meds I am as careful as I possibly can be, I made a spread sheet and fill it you so there is no chance of me over taking my meds or messing up on them because he has me on several different meds a total of 6 to be exact. In addition to the ones I listed in my first post I am also taking Zanaflex 4 mg for spasms sometimes during the day instead of Valium cause I save then Valium for night time or when it is really bad which is most of the time. I can only take one or the other not both. I am also taking Toradol for inflammation pain only once a day and my primary Doc put my on Ambien which I can't take with the Valium either. By the way the Ambien don't help me sleep so I stopped taking them cause why bother taking more meds for no reason? Sorry back to the point of calling my doctor and leaving a message. The nurse called me back about an hour of two later she said hold on for your Doc. He got on the phone and said it seems like you are going though you meds to quickly either you are taking them like M&M's or you could be selling them. I said WHAT? I said I take them exactly like you told me to take them and this is the first time I was calling since my surgery it has been 20 days now. He really hurt my feeling because I thought we had a great patient/doctor relationship and he has been my doctor for over 2 years and 2 surgeries later. I explained I take everything exactly like you told me to and I only take my meds when I am in pain which is most of the time or just before so I got get behind and end up with nothing in my system and have to wait a half hour in extreme pain until something kicks in. But the last thing I am is a drug addict or abuses my meds. He said I have no problem filling them for you but they have to last you at least 10 days so the RX will be at the front desk. I said these have lasted me 20 days and you’re treating me like s—t. I was so upset I made copies of all my spread sheets of my meds along with a letter and brought it to his office. I asked if I could talk to him when I got there and of course she said he was really busy which could have been true because there must have been 10 people in the waiting room. I told her that I was there to pick up my RX and that he hurt my feelings with what he said. I said the she was sorry he gets like that on the phone and he has a horrible bedside manner. I said in 2 years of appointment and 2 surgeries later I have never had him talk to me like that she said he is great and wouldn't do that in person but he gets complaints all the time on the phone. Anyway I got my RX and left. My next appointment is going to be a little uncomfortable unless he mans up and calls me to apologize which I know won’t happen. Sorry to go on and on but I am in a lot of pain and this added stress didn't help. He never gave me a back brace so if you do something I wasn't supposed or bend too far it's on the floor and I realize I went too far. The shoulder pain has let up a bit but the back pains seems to have increased maybe it feels that way cause I am focusing more on tmy back because my shoulders don't feel as bad. I actually slept for 2 hours at a clip and 4 1/2 hours for the night. I can't tell how good it feels to get a little bit of sleep, but I when I wake up it takes me quite a while to get out of bed cause the back pain is soo severe and tight I can't move much without shooting pain down my legs, up my back and wrapping around my stomach.. My quality of life feels like it is declining fast. i have decrease the meds like my doc told me but I can't barely stand the pain and I don't know what to do. If I take a little more meds when it is unbareable(sorry for the typo no spell check) Then I will run out of meds and get the third degree from my doc which if that happens again I a terminating our patiant/doctor relationship cause this is hard enough on it's own and not feeling like I am getiing any help or support for my own doctor feels horrible. Thank you for listening or I should say reading and responding. Thanks again Tony

[S. Kaul, MD]

Hi there!

It is common for it to take a few weeks for the pain and discomfort to settle after a spine fusion surgery. One is usually expected to wear a brace and limit motion around the spine for a few weeks after surgery after which physiotherapy is gradually initiated, while activities like bending, lifting heavy objects, and twisting motions would need to be avoided. Complete recovery may take as long as 3-9 months. For the shoulder and elbow pain it would be difficult to diagnose a cause without an evaluation. You could try some mild shoulder exercises and see if these seem to help. If you continue to have discomfort, it is advised to consult an orthopedician for an evaluation and appropriate management.
Hope this helps.

Take care!