Went to new pm doctor yesterday, after having increased and severe back and leg pain and increased numbness in legs/feet after having three neurolysis procedures in Sept/Oct for scar tissue around my fusion site.
First off, he was very kind. Will have to say that this has been lacking in my very fragmented care over the last year. He was trained in India and the US. Secondly, he does not prescribe meds, which is great since my preious pm doc made some accusations that I did not appreciate. I had never seen or needed a pm doctor before September, and this issues that I had have been a huge lesson learned. I consider myself new in this chronic pain arena.
At any rate, I was so happy to see a pm doctor who would concentrate on a diagnosis and plan of care. He does not like RFA or lysis of adhesions, but uses blocks, PT, some chiropratic tx when indicated, and then finally surgery when indicated. He does feel that meds are appropriate for chronic pain as well, he just doesn't personally prescribe.
My fusion is L4-5, but I had degenerative changes on L5-S1 facets even before my fusion, which my original surgeon did not want to address. I also have SI joint instatibility causing the greatest severity of pain that I have. I have also had thoracic pain since April. My NS got xrays in June, but did not address them at the time. The xray mentioned some scoliosis, and narrowing at T7, and kyphosis is pronounced, and that radionuclide bone scan may be helpful. Not addressed.
Yesterday it was interesting to note that my upper body reflexes were normal, but my lower body reflexes were exaggerated.
My new pm doc is getting a thoracic and lumbar MRI, with and without contrast on Wednesday, then I see him that afternoon.
He did say that he could not comment on the status of my fusion (I have delayed fusion at one year out). I asked if I should get a second surgical opinion. He said yes and no.
We will wait to see the results of the MRI. I am going to see a fellow trained orthopedic surgeon that actually is in the office of my pm doc. He probably has one of the best resumes in my state. How bad could that be?? (taking words from my favorite cook-barefoot contessa).
In anesthesia, we see the problem, react to the problem, fix the problem...not so in the spinal community. For every symptom, there are 500 causes, and then a variety of solutions. I'm accustomed to getting quick results. This year has been a steep learning curve. My brain is saturated with information. Very confusing.
I just read about the reflexes, but for the life of my I can't remember what I read (those darn meds causing memory issues again), so if anyone can point me to some information, I would greatly appreciate it. I do have a few ideas that come to mind, which I'm not to keen about.
Thus I continue with this spinal journey....just seems like yesterday I had a wonderful career, walking 25 miles a week, playing Rachmaninoff on the piano, scuba diving...would just like a little sliver of this back. I'm determined...I just need really good clinicians around me to help me through it.
Sorry for the long post!