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Pediatric Newbie*

Mmaem03MMmaem03 Posts: 53
edited 06/11/2012 - 8:22 AM in New Member Introductions
Hello Everyone~
I've been coming here for a few weeks to read everyones postings. I must admit at first It scared the hell out of me. I began to think I would never be free of the pain. So many of you suffer and for so many years too.

My story? I first started having lower back pain in my late teenage years. Due to the nature of my employment back then I was suffering regular bouts of lumbar pain in my early twenties. I'm now 37. My four pregnancies were progressively harder in regards to my back pain. I've always had buttock pain during these episodes. This year was the first time I've had full blown sciatica.

This summer July 10th it started. At first I tought I had over worked a few muscles I hadn't used in years. Not so lucky. After I realized it was getting worse and progressively lower in my leg I went to see my primary dr.

He gave me some muscle relaxers and told me to take ibuprofen 600 mg every six hours. He also set up PT for me right away.

After three weeks of PT with no positive results my primary ordered an MRI. Here are the results......................

Findings: There is no evidence of fracture, subluxation or significant loss of vertabral bodyheight. No abnormal marrow signal or abnormal cord signal is seen. Ther is disc desiccation at the L4-5 and the L5-S1 levels. Associated loss of disc space is seen at L5-S1.

At the L3-4 level there is disc bulging with a small broad-based posterior and central disc protrusion. Disc material abuts and mildly indents the ventral thecal sac. There is mild acquired canal narrowing at this level. The neural foriminal remains patent.

At the L4-5 there is more broad-based disc bulging which abuts the ventral thecal sac. Note is made of a small superimposed posterior and central high intesity zone/anular tear. No evidence of central canal stenosis or significant foraminal narrowing.

At L5-S1 there is disc bulging with a superimposed left pericentral disc protrusion. Disc material asymmetrically encroaches the region of the traversing left S1 nerve root, obscuring fat planes ventral to this structure. There is no evidence of central canal stenosis or significant foraminal narrowing.

My Primary recieved the results and told me I had a few herniations. He suggestd a I see a pain specialist.

So I did. My first visit I recieved a caudal ESI. It made my pain worse for about five days. After that I did get some relief. The shooting pains stopped and I was able to start walking a little better. Two weeks later I had my next appointmant with the pain doc. This visit was much different than the first. The dr treated me as if I was being a big baby. He asked me why I wasn't improving at a faster rate. He called me his Pediatric Patient* and said I should have been doing much better by this time.When I asked for the two additional weeks off work my PT suggested, he said he wasn't comfortable giving me any more leave from work. When I told him I could only sleep for a couple hours at a time because of the pain he reluctantly wrote a prescription for Ultram 50 mg. That day we did the second ESI.

After that appointment I decided to educate my self and try to figure out what those MRI results really meant.

I think I have a good understanding now and I'm wondering about the issues at L4-5 level. That central high intensity zone/anular tear wasn't even mentioned in the "impression " notes at the bottom of my MRI results. If I understand all that I've been reading that tear could be leaking nucleus material onto my nerves. This is what I have so many question about. So in which category would you all suggest I start asking all my questions? I'm so glad to have come across this message board!

Thank You in advance!
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Comments

  • Annular Tares can be extremely painful! I would definitely find a new doc and would have done so the minute he called me his pediatric patient. We must take control of our own healthcare in order to ensure that we are getting proper treatment. Please take your MRI results to a spine specialist. I also had an annular tare and understand exactly what you are going through. There are options available to repair the tare. Good luck and please keep us posted.
  • So if it turns out to be a grade 4 or 5 tear,is there no chance it can heal on it's own? Dose it have to be surgecley repaired? Like I said I think the ESI are helping some of my symtpoms. Maybe reducing the protrusion that is smashing my S1 nerve root but, can the cortisone help a tear that severe? I've already decided to get with my primary for another referral. I'm seeing him in the morning hopefully. He's a good guy. He takes care of my whole family. We like him.
  • :) hi and welcome to the forum! we are here to offer you support and answer what questions we can. regardless of your age you should be treated with respect. perhaps you need to keep looking for a pm who does just that. i am sorry you are having such pain. there are medications out now for the sciatica you are suffering from. these nerve pain medications can really help. as well your pain medications sound insufficient. as always your doctor is your best source for advice. please take care of yourself and take advantage of the forum for some laughs or some serious conversation. good luck! Jenny :)
  • Bless his heart I think I may have a better idea of what is going on than he does. He gave me a referral for a spine
    surgeon. He gently kept trying to get me to wait on taking the option of an OS/NS. Mainly because I am seeing some results with the ESI I've been getting with the pain doctor. He thinks I should give it some more time to work and see its full effect.

    Thanks for all your welcomes! This place makes me feel better. :) I'm glad to soon be getting another professional opinion.
  • HI Pedi,you need to see a spine specialist, either OS or NS. The LESI's don't repair anything, they just treat/mask the symptoms. Good Luck, Sue
  • So I went back to the pain guy. He placed the injection higher yesterday. I asked him what would be next in my treatment and his reply was "nothing, there is no next." I have a follow up in eight weeks. I still can't sleep for more than an hour and a half at a time. I don't know how I'm supposed to go back to work next week. This sucks. I'll probably end up in the whacky shack before I see the spine specialist on the 17th!
  • mmaem- I believe that that the ESIs are given in a set of 3 but his answer really was insensitive. :T He should have explained about the series of 3, what to expect, any questions you have or possible side effects.

    When I had the series of 3 ESIs, I went into a high energy mode. Too bad I was in pain or I could have cleaned my house from top to bottom. I was always hungry, wanted to eat non-stop, had hot flashes and had a hard time sleeping as I was extremely hyper from all the steroids. I was angry as well at times for no reason. I would just feel a fire like feeling creep up on me and I would feel mad at this or that- for no reason. X( ..I hope you find someone else to listen and help you as your pain is real. It is wrong to call you a big baby (pediatric patient!?) in such a sarcastic fashion.. /:) jade
  • Jade~ hello. I knew about the series of three. Not because the doctor explained it but because my PT told me. I wasn't expecting more injectons. I was just wondering about controling the pain that the injections haven't helped. After each injection I had increased pain for 4-7 days. I expected this as I was informed it could happen. My over all pain has only improved in some respects but has become worse in others. I'll explain.. In the beginning before the first injection I had alot of shooting pain and could hardly get up and down from sitting or lying in bed. The first shot took care of that. But by then I started having pain while lying down which wasn't much of a problem before. Laying on my tummy used to give me some relief.It really started to effect my sleep. I was able to sleep for 5 hours without pain getting me out of bed.Which wasn't bad ,I could have handled that. Two weeks after the first shot I had the second one. After that one I "loosened up " a little. I was capable of a bigger range of motion. However the pain became constant and sleeping has become nearly impossible.As I'm active during the day, most of the time I can put the pain in the back of my head and function some. Ofcourse when I try to lay down to sleep the pain increases and I'm now only able to sleep for an hour and a half at a time because its become so bad. I'm awake all hours it seems. It's worse than having a newborn baby in the house! Also after the second shot I started getting leg jerks as I start to fall off to sleep.Wierd. As if sleep wasn't hard enough to achieve! I aske d him about it. He said everbody does that. I told him it has happened to me before but only once in a blue moon, next to never. I asked if it could be a side effect from the cortisone. He said no. He gave me Flexeril to try before I go to bed at night. I laughed and said which attempt are you talking about?

    Anyway I feel like he isn't concerned about my level of pain or lack of sleep. I'm over it. I see my primary this week. I'm going to tell him about the leg jerking and my pain and see if he won't prescribe something different than Ultram. The pharmacist called me today to tell me that taking the combination of prescriptions I have isn't a good thing. She's concerned I may get too much seritonin flowing through my viens. She also thinks this may be causing the leg jerking as I'm falling alseep. I'm taking Cymbalta 60's, Ultram 50's, and the Flexeril. I'm so anxious to see the NS next week. From what I've read he's the very best in my part of the state.

    Sorry to hear you had so many bad side effects from your injections. I'm lucky. I only get hot flashes once in a while and I do sweat a whole lot more. As for my temperment It's been fine. Lately there seems to be a lot of love in the air at my house. Lots of affection ~ hugs and smooches.The whole family is getting mushy, me,my hubby, and all four kids. I'm loving it!Maybe too much seritonin isn't a bad thing after all,lol.
  • Mmaem03, Hello, and welcome to this site. I have to laugh when I read your posts. I know exactly what you are going through.

    If you read some of my posts under pain medication, and pain management you will see I have been given quite the run around with my doctors.

    My neurologist started me on morphine for pain, which made me severely ill. Now he has me on ultram, which seems to keep me awake all night. I can't take it really anytime in the afternoon, as even with valium I can't sleep. A lot of people on here have said they have the same problems.

    I hope that you will get the answers you need from the NS. I was opposed to surgery myself, but my primary insisted, or shall I say demanded I have it done. Since then, I have seen a PM, Neuro, and NS all of whom said absolutely no surgery.

    I hope to see my primary next week, to have him take me off ultram. My neuro doesn't believe that it is the cause of my issues. I plan to print up a lot of research, and present it to my primary.

    Good luck, and lets us know how you are doing
    Amanda
  • P.S.

    I think it was very rude of your PM to call you hid pediatric patient. He is in charge of managing pain. You most certainly can't be the only patient he see's who is still in pain. How dare he even say something like that to you.
  • bumpity bump ,bump for formerfire
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