I need some advice and ideas on how I can make Dad's life better and what options he might have open.
* Dad is 49 yo, worked as a machine operator (lots of bending+lifting) for 15+ years.
* Had had a history of mild lower back pain that was treated with physio whenever it flared up.
* Had Ulnar nerve problems in right arm in 2013 Sept causing him to lose arm strength and feeling. Performed a ulnar nerve release in the elbow. Recovered reasonably well. I guess the intro to chronic pain started there. His hand recovered and didn't need pain meds afterwards for about 4 months. Cervical issues hinted in Cervical MRI (degenerated discs and pressing on nerves along with stenosis).
* After starting work in Dec 2013 Dad shortly developed SEVERE back problems from Jan/Feb 2014. Lots of lower mechanical back pain, shooting/burning pain in legs causing them to weaken and cramp. MRI revealed bilateral foraminal stenosis in lower back on a few levels most severe at L5/S1.
* He got a nerve root block injection on L5/S1 for relief. It seemed to work. He followed the specialist advice and took time off work to continue physio and resting. He did some swimming as well.
* By March/April the pain had returned despite physio and other therapies. The pain was worse than before and he was growing desperate. He decided to undergo a L5/S1 PLIF laminectomy, rhizotomy and fusion in June 2014. By this time he had suffered a lot and had developed depression and anxiety. This was party due to the fact that our GP failed to provide adequate pain management and Dad tried to endure it and be stoic.
* 7 months post op from the fusion. Initial recovery and healing went well. Fusion had occurred at the 6 month mark but no union yet. He can do most housework and does about 4KM walk a day.
* Right Shoulder pain and loss of movement started a few weeks ago (Dec 2014) which has cause some of the worry and anxiety to return. It could be a cervical problem. Another Cervical MRI was done and it showed significant issues with the cervical spine. The treating dr instructed nerve root blocks (foraminal) on his right side but that made the pain worse (did not provide relief).
* Recently found out he lost his job which has caused a flare up of pain and depression this week. The pain had reached a level of 7 in scale and we went so far to request hospitlisation. Thankfully it is better today. He got a CT scan done yesterday and it showed up clear. He is getting an MRI of his back to make sure his fusion is going ok.
* Currently his depression and anxiety is growing. Especially after finding out about his redundancy at work. He feels like there is no fix for him and that he is worthless and a burden. He simply keeps thinking about this most of the time in the past few days and crying a lot. We try to comfort him but his pain mixed with his feelings is very overwhelming for him.
* Using Lyrica 75MG twice/day and has had to start taking Endne 5mg twice/day to control the onset of shoulder pain and general pain that has started in the past month. He had given up endone and reduced Lyrica by November when things were getting better.
* What is the prospect for my father? It seems there are ongoing issues with his whole spine (cervical and lumbar) and he is suffering mentally and physically. I know there are a lot of people out there who have made do with a lot more pain and issues but Dad just seems to have lost hope. It looks like there will have to be a discussion about further surgery at some time but we are scared to go for it. I often lament the decision for the lumbar fusion. He is so much weaker as a result especially at such a young age (49 yo).
* There is also the issue of not ever finding a clear diagnosis. This is eating him inside because he does not know how things have gotten so wrong with his body. He is type of person that worked hard and stayed busy throughout the day. Right now, he has trouble even lifting and moving (made worse by the shoulder troubles recently) which is frustrating him and making him feel like he is trapped inside his body with all this pain and inability to get better.
* My next course of action is looking to get him into a pain clinic that can offer him advice and treatment through a multi disciplinary approach. Right now he has separate physio (works hard for Dad) and psychologist (who isn't the best for his condition I think) but I think a pain clinic might be able to help him deal with accepting the chronic pain and manage his pain better.
* Secondly, I need to get him into hobbies or better yet some sort of part time work/volunteer job. I think without work or staying busy he will go mad.
Thank you for reading.