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3 Doctors. 3 Opinions and one really confused patient

tonya42ttonya42 Posts: 810
edited 06/11/2012 - 7:28 AM in Back Surgery and Neck Surgery
Has anyone else ever hoped an ESI injection didn't work? Well I am. For anyone who doesn't know me. I had a collision with a semi back in Sept then ACDF C5 C6 in early October. I've been through PT and still had severe shoulder and neck pain. I couldn't get answers about my shoulder pain so I went to see an Ortho who specializes in shoulders who told me the pain is still coming from my neck and sent me today to see a new Ortho who specializes in necks and he agrees. So his recommendation is that I have 2 ESI injections beginning Wednesday as a diagnostic tool to see if the pain is coming from the level above. He says that there is too much movement between C3/C4 seen on the MRI and that is what is now causing my pain. So now I'm faced with another surgery if the ESI injections work he will know that IS the cause of my pain. I am going to continue with my Myofascial therapy and get the 2 ESI injections and go from there. Has anyone ever had this happen? I can't imagine that I'm the only one. I was FLOORED today. I never even saw this one coming either. Just like the semi. :(
If you've had ESI injections I would love to hear what I can do to minimize the pain on Wednesday.


  • Hi tonya,
    I have had lower back esi's but not neck. If you are that unsure, go to a neurosurgeon for advice. a neurosurgeon and an ortho are looking at two different angles. a neurosurgeon knows the spine and spinal cord and that's who I would see before I had any esi's to my neck. feel better, Cher
  • I think this is actually being done by an anesthesiologist at the hospital my ortho works at. If I need surgery though I would weigh the pros and cons of an ortho vs neuro before I have anything done that is more invasive. I just want to know what to expect after the ESI and if there is anything that I can do to make sure it is not painful.
  • I at least have myofascial to look forward to tomorrow. I really expected that when I showed up in his office this morning that he would say something like, "Well let's keep up the therapy and see how that works." Instead he looked at my motion MRI and noticed the other discs. I can't believe that I'm about to say, "I hope ESI doesn't work Wednesday." I know everyone else around here is looking for relief from it. I'm not because it only confirms that I'm in for more surgery. I am still in shock today. :(
  • Sorry to hear you may need surgery again maybe. I had lumber ESIs only. They mainly helped the leg pain but I know it's for diagnostic reasons. Ask them about facet joint problems. The 2nd PM Dr I went to diagnoised that and gave injections there. I hope everything works out for you.
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • I have had those to confirm what disc was the problem. I have also had selective nerve root injections as well. As you know my story is quit long with the number of surgeries and I was also involved in a MVA. None the less you should hope they find the pain generator as well. Once they identify what is causing the pain it can be treated. Hopefully, that will not require more surgery. Since you have been down this path before you know what to expect. Another thing that you have to keep in mind when it comes to fusing there is greater pressure put on other disc. Hence when i was reading on one of the risk of surgery, that i signed off on, was the need for further surgeries in the future. I will tell you that my surgeon was not that confident in the MRI without contrast and sent me for a myelogram followed by ct. I noticed that you said they were concerned about motion. The fourth surgery I had was to correct rethrodesis(sp) which means that the one level is moving on top of another level causing instability. This can be seen on a flex film as well. Rather hard to dx on standard MRI's for the fact you are laying flat for that test. Where as the myelogram has your neck in the extended position.

    As far as minimizing the pain from the ESI i really had no issues. I have done all the injections under local anesthesia to the injection site. If your concerned about the pain they can give you a general for that. If your going for myofascial massages, is it possible to have another one the following day. I have one of the ESI's about a day afterwards bring the pain on so bad that I called the ordering doctor to beg them to get it out of me. Apparently they were trying to recreate what i go through. At that point and time I was very new to all this, and didn't realize what they were doing. The pain lasted for about three days as apparently it wouldn't pass the space and was setting right on the nerve. I can tell you the selective nerve roots I really enjoyed. The last one I had decided not to go to bed till it wore off as it had been so long that i was almost pain free. Unfortunately it only lasted about two days and the pain returned with a vengeance. I can tell you I have had a fusion that compromised the same nerve that was released as well. Anyway good luck and keep us posted. If i can help in anyway don't hesitate to pm me. Sorry about the bad news.
  • Hi Tonya,
    So sorry to hear what you are going threw. I did have the ESI'S in the neck twice and than after relief I had the RF done leaving in so much pain in my head I ended up in ER all was ok after they did a MRI to make sure nothing happend during the RF. I know am back to square one and would never get anything more done with my neck after the RF scare. I wish you luck with whatever you think you should go with. Make sure you trust your Dr. or go for another opinion. I just had my secound RF done on my L.B 3 levels both sides and it did not work as good as the first looks like I am going to see Dr. about the s.c.s Just to give you an update on me. Well, I know the injections in the neck seem to be more scary than the back. I did have meds to knock me out so, I can't say if it hurt or not. Just let the Dr. know of your fear of the pain. Again good luck and let me know how all went. Blessing to you.
  • I always follow you around here because it seems we have much in common. My only hope is that it doesn't require I have anymore surgery. There has just got to be another way. But I'll cross that bridge when I get to it. I have one thing going for me this week I think. I have a PT appt for Myofascial Release tomorrow and Thursday. With the ESI in between. I was wondering if I should reschedule my Thursday appt. but it sounds like that may be my saving grace this week. I talked to someone in the imaging place where I will be having this ESI and they don't do any anesthesia just a local. He said the whole procedure takes less than 5 minutes and they will have me in and out within an hour. He did however tell me to feel free to take my Valium and Tramadol just before the procedure if I want to and if it relaxes me.
    Thanks for the response. I really needed to hear today that I'm not alone in this.
  • Ok educate me. What is an RF is that where they go in and burn the nerve? If so I don't think I could ever let them do that. I've heard some real horror stories about that procedure.
  • I have only had lumbar injections. They really didn't do much for me at all. I am sorry to hear that you may need surgery again. Please keep us up to date. ((Hugs)))
  • I know how much you're going through. It means a lot to me that you stopped by for a hug. Back at you sweetheart.
    Like I said I'm hoping I have the same result as you. That it doesn't give me relief. If it does I'm screwed literally only this time at C3/C4. :)
  • I had my first ever ESI injection today and it wasn't NEARLY as bad as I thought. All of my right side symptoms are gone now. No more tingling in my fingers so it looks like my new Ortho Doc was right. I'm kind of a mixed bag of emotions today. On the one hand I'm glad I no longer get a stinger all the way down my arm when I move my head but it also means that the new Doc was right and I will be going back in for surgery eventually. I can't live on ESI's for the rest of my life. I just hope this lasts long enough to help me muster up the courage for surgery again. Has anyone ever had a plate just extended to the next level up? He's not talking about fusion this time just extending the plate to stop the movement. I've not come across this one before.
  • Yes tonya although they were adding another level to the fusion they couldn't get the other hardware out so added it on to bridge. Now I hope your surgeon is going to take out the original plate and put in a double plate. Because of adding a second plate in and not removing original is why i had to have that plate removed. The plate was into the eshophagus and was tearing it up. Not to mention always choking on foods. There is just not enough room in the cervical spine for that. So if that is what he is going to do i would assume he will just replace the plate with a larger one. Keep us posted and glad to hear the esi worked. I have heard of members having a esi after surgery and the pain going away like a little boost. I hope this is so in your case.
  • He is going to just remove the original plate and put a longer one in or so he explained to me. I'm just skeptical about him removing the plate since I had such a great fusion going on at C5/C6. I think I said C3/C4 in my other post. He's only going to C4 and hopefully that will be the end of this saga. I always knew there was a possibility of the level above or below having issues I just never in my wildest dreams it would be within 6 months of my first surgery so I was really caught off guard. I hate to know that I'll have surgery pain again since my arm feels so good today. Geez... The trade offs we spineys have to make huh? :)
  • I love my Physical Therapy. It's always the bright spot in my week. I just wish that my original surgeon had recommended myofascial release therapy before now. I suffered through muscle pain that was completely treatable and it just makes me so frustrated with him that for months he just kept giving me muscle relaxers and not fixing the problem. It just stinks that I now am almost pain free and will have surgery again because he wouldn't do the right X Rays either. (My back hurts pretty bad today from the injection. But it's controlled with my Tramadol.)

    OH P.S. I saying MRI in my other posts he found the problem on a simple X Ray and then looked at my MRI to come up with his diagnosis. You know you have so many procedures you tend to get them mixed up after a while. :)
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,732
    I had a lot of ESI's for lumbar. they didn't hurt to bad and they allowed me to get another 2 or 3 years of work in before I eventually had to have surgery. They were very successful for quite a while.
    I was gone for quite sometime and then my wonderful windows vista was giving me a lot of trouble, so I haven't been around much lately. I think I finally have this computer fixed (knock on wood)
    Whats this Myofascial stuff, It sounds kinda nasty, LOL }:) image:)" alt=">:)" height="20" />
    Good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • I can't believe that you've been going through all this while I've been away!

    Don't jump to conclusions too soon. It is possible that you may not need surgery and you need to work towards this end result. I had some instability during my fusion process too and it resolved itself- no injections or surgery needed. Of course I'm not you and you need to do whatever makes you whole and happy.

    All I can give you is support right now as even hugs hurt too much LOL. You know I'm here for you and will try to write as often as possible. You'll be in my thoughts no matter what.

  • No Myofascial Release is WONDERFUL! It has relaxed those really stiff muscles in my back. When she first started I had knots all up and down my spine and into both shoulders. The last time I saw her my muscles were MUCH more relaxed. It's a type of massage. Not the kind you're probably visualizing though. She really gets into the mucles with her hands and holds them for a few seconds and then releases them. It really does feel good when she's done that is until she makes me do my exercises to strengthen my shoulders. :)
    I'm glad Vista has finally quit giving you fits. I've told you I'll send you XP if it gets to bad. My offer still stands.
    Good to see you around here again.
  • How on earth are you answering posts? Aren't you suppose to be resting or something? I'll have to call your doc and ask that he give you better drugs because obviously you are alert and attentive and you shouldn't be. :D
    Now to answer you. I've seen the X Rays but now you have me going hmmmm.... I was about to call him this morning and tell his office I want his next available appt. to schedule this surgery. Heaven knows if there is a possiblity that it could resolve itself of course I would MUCH prefer leaving it alone. Thanks for letting me know I may have an option.
    I can give hugs since my fingers still aren't tingling. >:D< >:D< >:D<
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,732
    I have a Sundance aqua therapy spa that can be adjusted to give me almost any kind of massage I want. And direct it to go where I want it to go. It works great for my neck and shoulders. Or I can adjust it for any part of my back, hands, arms, ect. It's a real life saver for me! I love it. Just about the best money I ever spent! If anyone is interested, beware of cheaper imitations.
    It's good to touch base with you. I've been following all your posts. Playing catch up.
    Good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • Ok. This morning completely out of the blue I got a call from my surgeon's nurse. I'm now just sitting here waiting for them to call me back together so that we can get a game plan together. I'm still so torn about this. I have just one question for him that will help me make up my mind. If this surgery gets rid of my shoulder pain then I should be having surgery very soon. If his answer is vague then mine will be too. Say a prayer. Wish me well. Hold my hand. Somebody give me a hug. I'm shaking all over. Of course I DO NOT want to have yet another surgery I do however want my life back. Any words of wisdom are greatly appreciated.
    (Griff you better be sleeping right now young lady!)
  • Yea, right. You try sleeping with a 12" knife stuck in your back, hahaha!

    Tonya, seriously, if he promises that this surgery will get rid of your shoulder pain 100% I'd be very cautious of that too. No surgeon can make those kind of promises. This is one of those cases that I'd think about a second opinion. If you do indeed have instability that's enough reason to go under the knife but you can't expect anything except the fact that you spine won't move any longer to cause more damage. Does that make sense?

    Sending all the hugs, well wishes and whatever is needed to get you through it. A little extra too for calling me "young lady" LOL.


  • I have a date. It's April 21st. Which gives me plenty of time to go back to see the Neuro-Surgeon who diagnosed my Chiari Malformation. Today his nurse is calling in about 5 prescriptions for various things to help me get through until surgery without heavy duty pain pills. I told them good. I have a purse full of pills and I don't take any of them. So we are going to slap on a lidoderm patch to see if it helps the shoulder pain. Though she isn't convinced I am and that's all that matters. She is also calling in Tramadol, phenergan and Chantix so I will quit smoking. I hope it works because it's a really bad habit that I'd like to kick just because of my overall health not just the surgery results. I think I'm living proof that smoking doesn't always equal failed fusion.
    Oh this doctor and I may not work well together. First he insists on using bone from your hip. I told his nurse no there are plenty of cadavers at this hospital go find one with good bones. :) He also likes to prescribe Lortab, Vicodin or Norco after surgery. I told her great then we can all go down to the ER together because as my chart states I AM ALLERGIC! Geez. So Griff you're right. I'm going for a second opinion. I don't think this is going to work out unless his staff suddenly becomes very nice and accomodating it will be hard to work with him.
  • Ok. Tonight I am trying the Lidoderm Patch for the first time. I am just wondering how long it takes before I feel the effects of it.
    Tomorrow I am calling the Neuro Surgeon for a second opinion. He already has my MRI and I'm going to ask if I can fax or email my X Ray's and go see him or have him call me or whatever. I didn't like the new Doc's LPN when she called with an attitude today and pretty much told me how it was going to go even when I told her NO. She insists this doc will only use my own bone. I told her no. I did fine with the cadaver bone and didn't need hip pain afterward to deal with as well as neck pain. I'm sick and tired of trading symptoms and issues for one another. But she just KEPT insisting. I don't know this doctor all that well and I am going to do it my way or he isn't going to do it at all. Somehow she forgot today that I pay her salary and if I have surgery I'll be paying a huge chunk of it this year! Oh and he (the doc) never once mentioned removing the disc but rather just adding a plate and when I tried to explain that to her she just insisted that's not what he's doing and he is doing an ACDF. That is not what he and I discussed. Anyway to wrap this up this is not sitting well with me tonight. Hopefully the Lidoderm patch will stop my shoulder pain so I can think straight until I get a second and perhaps 3rd opinion. I'm not going to be cut on by a doctor who has a staff with such a BAD attitude because it is them that we all have to deal with afterward.
  • We sometimes don't realize just how important the support staff are until you get the bad ones. You need the whole team to be on the same side, with the same information and goals as you have. So good for you for the second opinion. It's exactly what I would tell you to do.
    You go girl!

  • I am sorry you are going through all of this...I was so hoping your shoulder pain was something minor or at least requiring less invasive treatment. It is good to go for a second opinion; especially since you don't feel comfortable with the doctor. feel better and keep us posted. Donna
  • I think I'll get me one of those. I'll have to do some homework today to try to find one. I love water and it sounds so relaxing.
  • I just want to go Ha!Ha!Ha! to the Dr.'s LPN today. The Lidoderm patch worked it's wonders last night. I woke up with this morning and my shoulder doesn't hurt at all and I can only believe that it's the patch that did that for me since I didn't take any pain pills last night or sleep aids or anything for that matter. So it must have reached the nerve that I knew was causing my problems. I am calling my Neuro today and see if I can get his opinion. I'm even considering calling my original surgeon back. He did good work technically it's just that he didn't believe my pain in the end and that was so disappointing to me. I loved him and his staff afterward. They always returned my calls very promptly. They were always very attentive and so far I am NOT getting that vibe from this new doctor. As a matter of fact I can't even get to talk to him. I just don't know what to say to my original surgeon. Any ideas about how to approach him with this? I'm all ears.
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,732
    Hi Tonya,
    where did you put that patch to get relief? On your shoulder or on the area of the disk. Cause if you put it on your shoulder and got relief. Then its probably a shoulder injury of some type. If you put it on the disc then it would probably be a nerve damaged by that disc.
    At any rate Ive used them for years. But if you use them on a daily basis they lose there effectiveness after a given time.
    My wife had a shoulder injury, a bone growth irritating the rotator cuff. I gave her some patches and they worked wonders, but only for a few months. Then they became ineffective. Same thing with my mothers hand.
    remember you can put up to 3 patches on at a time, but only for 12 hrs. on and 12 hrs. off.
    If you put that patch directly on your shoulder and got relief. Don't you think you might be wise to get a shoulder mri? And make sure the shoulder itself is not injured.
    Well stay in touch and good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • Funny you should mention that. That is the VERY reason I went to see another doctor. My original surgeon was convinced that the shoulder pain and tingling in my fingers wasn't coming from my neck. So I went to someone who specializes in shoulders. He X Ray'ed my shoulder and did his exam and said that it wasn't coming from my shoulder so he sent me to this new Ortho Surgeon. That's how I ended up where I am. The new spine surgeon did his own cervical X Rays and said that there is too much movement coming from C4 (The level above my fusion.). I have gotten so good at anatomy now all I have to do is go to med school and get my degree. :D I figured out where that nerve from my C4 runs through my trapezius and put it there so hopefully it would reach the nerve. I was right and so was he. The nerve is being pinched by my neck. I also had an ESI injection which had the same effect only it just didn't last very long. They offered to do a second one next week but at this point I just had to say "No Thanks." It left my back muscles in spasms for 2 days and if the nerve is pinched then I'm just delaying the inevitable. But in the beginning I was convinced that it was something torn in my shoulder. Kind of wish it had been. I'm not looking forward to a second ACDF.
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,732
    That often happens with adjacent discs. About a year after my 3 level fusion the next one up went out and had to have that fused. Now 3 more are blown out. I should have got a artificial disc with shock absorbers
    Good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
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