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Need advice on doctor and work. bulging discs and sciatica

First I will give my back story on when my problem started up to now. In July 2013 I noticed I was having tingling in my calf and foot. I brushed it off as cutting off circulation from wearing new shoes that were too tight and my unloader knee brace constricting blood flow possibly. This went off and on most of the summer and I would have occasion bad lower back pain that would last no more than a couple days at a time about every couple of weeks.
By the end of August beginning of September the lower back pain and foot tingling got worse. I was in pain all the time and the tingling was constant. It was making work hard and I was not getting very good rest. I made an appointment with a new primary doctor in September. I told her everything that was going on and she sent me in for blood work and an xray of my back and neck because I had tingling in my wrist and fingers too. A few days later the nurse called me and said my blood work came back really good and my x rays looked fine, but the doctor wanted me to go to physical therapy. I went for one visit and continued the exercises all weekend. By that Monday I was in excruciating pain so I stopped the physical therapy. I gave it a few days to see if the pain would go away and it only got worse.
I went into urgent care and was told that it sounds like I might have a herniated disc and a pinched nerve. He prescribed me tramadol, zanaflex, and prednisone. I had very noticeable relief while the prescription lasted. I was also referred to an orthopedic surgeon. I went in to see the ortho the very next week. He had me get an MRI done on my lower back and an EMG done on my hands. The EMG came back as carpal tunnel syndrome in both hands. I had surgery on my left hand in December. The MRI results came back with a bulging disc and a tear in my L4/L5 and a bulging disc in my L5/S1 which was causing my sciatica issues. I had the MRI on October 28th and followed up with the ortho on November 3rd. He referred me to pain management for epidural steroid injections. Over the next few weeks I waited and waited for the pain doctor to call. I called the ortho to find out what is taking so long. Someone forgot to send the referral over and it was not sent until November 19th.
I did not hear from the pain clinic until the following week. I could also not get an appointment that week due to the holiday. I finally got into the pain doctor on December 3rd. The pain doctor asked me what took me so long to come and see him. I told him that is what I would like to know. He said he surgery would not be necessary and recommended ESI. He called my insurance company to get the injections approved while I waited. I had my first ESI that day. It worked wonders for my pain.
We had a snow storm on February 4th. I shoveled my driveway after I got home from work. When I finished up I came inside and felt dizzy and my lower back was throbbing. Instantly my back pain and sciatica reared its ugly head and was worse than before the injections with the pain going from my left buttock all the way down to my foot. I worked Wednesday and Thursday in excruciating pain. On Thursday the pain was so bad that I was seeing double. There were a couple instances where I sat down at my desk to sign invoices and my vision got blurry and I saw what appeared to be stars. I didn't get very much sleep those couple of days and on my way home from work I nodded off at the wheel and came close to hitting an exit sign off the highway before waking up and swerving back over into my lane. I called in Friday and went to the ER. They wrote me out a script for 5mg vicodin and 500mg robaxin. The vicodin was too weak and the robaxin just made me really tired. I missed work Saturday too and my boss called and wanted a signed work release before coming back to work. I made an appointment with the pain doctor this past Wednesday.
When I went to the appointment the doctor was a real a hole and acted like I was stupid for shoveling snow. It wasn't an option. I have nobody else to do it. My wife is pregnant and I did not want her outside doing it. He told me that he cannot give me any more injections for 6 months. I told him that I needed my work release signed in order to go back to work and told him that I did not feel like I was ready to go back. He did not even read the physical ability requirements or completely fill out the form. He signed it and checked it saying that I can go back to work without restriction. He also asked why I needed a work release when he never told me to not go to work. I had to explain the pain I was in to him and that I missed work for going to the ER and my boss wanted the release for me to go back. He then told me there is nothing more that he can do for me and that I need to make an appointment with a neurosurgeon. This is after just two months ago saying surgery would not be necessary. Why would he not write me a prescription for medication and just send me on my way? I cried when I got home because I was in so much pain and feared going back to work on Thursday.
I returned to work on Thursday 20 minutes late and when my boss came in he asked how I was dong. I told him I feel like hell and that I am hurting really bad, then he questioned why the doctor would sign my work release. I had a very hard time sleeping that night.I was an hour and fifteen minutes late on Friday. After work that day my store director and two assistants called me into their office. They questioned me on my plans with work and said I cannot be coming in late. They want me to get better and don't understand the doctors reason for giving me a 100% release when I am apparently still in a lot of pain. My boss said if I am late again it will result in disciplinary action. I have been on my job for 15 years, but at my current location. Before I was transferred to the current store I am working at I was never late to work. I was always early and think I may have called in no more than 2-3 times during a 13 year period. Just 3 weeks after getting promoted and transferred things in my life started going downhill. From March 2012-March 2013 I lost my brother to suicide, a good friend was shot and killed, and my best friend died of a severe staph infection. I suffered from depression and anxiety for a while after that. I sought help in March 2013 and am doing a lot better. I struggled with work calling in and being late quite a bit during that time, but my bosses allowed it because they understood what I was going through, but this time they are not being as understanding. What do I do when my pain management doctor says he can not do anything for me and I may face losing my job for being late, but due to pain and lack of sleep, not from being unreliable. What should my next plan of action be so that I can get better and prevent myself from losing my job? I am really scared because we have a baby on the way in July and I can't be out of work and unable to provide for my newborn child and I can't be in pain and unable to help care for my newborn. This is so frustrating and I have never been so miserable. I started developing osteoarthritis in my knees when I was just 24 years old and I am 33 now and my knees are in so bad of shape I already need knee replacements. I thought my knee pain was bad. It has nothing on my back pain and sciatica. I feel like I have no kind of life right now and really need help getting it back.


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    I'm sorry that you are in so much pain but it might be time to consult with a board certified spine surgeon, and see what he recommends as far as treatment goes. Not sleeping well is part and parcel of having spine issues, I'm afraid but you might want to try melatonin or possibly one of the over the counter sleep aids to help you sleep a bit better. Also a pillow under your knees might take some of the pressure off your spine at night as well.
    It does sound like along with the physical complaints you may be experiencing some ongoing depression as well.
    As far as the injections go, you really should not have gone out and shoveled snow right after the injection. The idea behind the injections are to soothe inflammed areas and reduce pain but shoveling snow might have just made the injection worthless . A young teen in your neighborhood or plow service would have been a better option.
    Since your job is your priority now, it would be worthwhile to make every effort to be on time and to do your job to the best of your ability. Most of us have to learn to adapt to manage our lives and our family obligations , as well as employment issues , and that means not doing things to aggravate the condition of your spine.
    Check out the forums called radiculopathy and sciatica. On the left hand side of the forums, you will see lots of links to more information about both conditions.
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