Mrs D--Good thought about Vit D--my endo ran it and said it's okay. And while prednisone and nsaids might interfere with healing, at this point they help inflammation and pain, and I think it's 6 of one, half dozen of the other, as to which is affecting me worse--inflammation or failure to fuse.

I can't find any good information on how long it should take to fuse, either on the forums or on pubmed. I'm sure it must be out there, but I can't find it. If anyone knows about this, I'd like to hear. Also, whether the instruments are expected to hold a person as if they are fused for over a year or how long?

because my surgeon doesn't care that I'm not fused, because he says the screws are so tight they do just as good as fusion.

I am totally at a loss here.

Haven't taken the Lyrica. Got it, but shied away at the last minute.

Update, Mrs D?
 

Last writing, I had had an MRI and CT of the spine which showed no particular reason for continuing pain after the laminectomy and fusion.
I was then sent for flexion and extension films to see if my back is stable or not, and the radiologist actually TALKED to me about what he found. (Actually, as I was sitting in the waiting room, he called several people in to tell them what he found, when he found nothing---told them to go enjoy their weekend and not to worry! A gem this guy)

He found my back is stable. The screws and rods are holding well. The bone transplant did not fuse at all, but that shouldn't be causing pain because the screws are okay. There's new arthritis below the fusion, which is common because after fusion the levels above and below are stressed. He thinks that may cause butt pain when I sit, and suggests a facet block.

Otherwise he says there's lots of scarring along the spine, which is NORMAL after fusion, and accounts for the pain people have starting at around 3 months. He said usually it goes away on its own at about a year.

I spent the last week concentrating more on massage and imagining anything which would break up scar tissue, and was actually feeling a bit better today when I saw my rheumatologist.

Once again, he recommended I take methotrexate. He says I have evidence of lots of tendinitis and low level inflammation at joints. He says this is what happens with sero-negative arthritis. He does not think I have osteoarthritis, rather inflammatory. Even though I'm not at all sure, myself, that I have any arthritis other than the spine.

He wants me to take 15 mg of methotrexate once a week, with folinic and folic acid. His idea is that I rate how fatigued I am and how much pain and stiffness I have daily for 6 weeks. If I'm improved, I can decide to stay on it. If there's no change, then I stop, and don't have to revisit this ad nauseum.

Six weeks seems manageable. Mrs D?

Also, he suggests I start Lyrica, 50mg at night.

I'm thinking both are reasonable, but if I do both together, how do I know which is working?

As an aside, especially for Mrs D, but for anybody: I take dexamethasone nasal spray and amphotericin nasal spray for fungal sinusitis. I haven't had an infection since last March, which is an amazingly long time for me. Also take diflucan, 100mg daily. I have just realized that I have totally lost my sense of smell. Is this from either of these meds? If so, do you know which? Is this reversible? I do miss smelling.

Brian--Only realized while re-reading this thread that I had lost track of the magnets. So I went back to the page, and I can't find a page 13. Can you send a direct link?

Overall, I'm feeling not bad. The back pain, while still there, may be less with more massage and feldenkrais type movements. Sinuses are good, and neuropathy is stable. Just tired--of dealing with the pain and, just tired from the pain.

Brian--Only realized while re-reading this thread that I had lost track of the magnets. So I went back to the page, and I can't find a page 13. Can you send a direct link?
.................................................. .................................................. ......

Here you go - :) https://www.magnet4sale.com/xcart4/h...tion=0&page=13

generalized arthritis
 

and food.

I have never taken immune suppressing drugs. I was tempted last year, but I stuck it out. However, I did find a food link to joint/tendon issues.
For me it was orange juice and other citrus. I bought the book by Dr. Kittley
Obesity's Answer ( www.obesitysanswer.com) and followed some of the
elimination diets. (Dr. Kittley is a GF advocate and linked to OBT on her site) I found onions and oranges were problematic for me.
The onions were mostly GI. But when I stopped all orange juice,(and oranges) which I love,
my knees stopped hurting. I was pretty awful last winter with the PT and then my knees flared up. I have tested it once recently with grapefruit..and the next 2 days I had knee pain. I have removed citrus from my diet now, and I have
far less pain (some stiffness remains).
I have read anecdotal things over the years, but never a direct link. Since I do not drink OJ at our summer place (hard to keep and get) I always feel better there. As soon as I get home, within a couple of weeks, my knees would act up again. I thought it was all the stairs I climb. But it is turning out to be the OJ. Since I responded so well to GF diet, I suspected other things..as Dr. Kittley points out in her book.

I really MISS my oranges too! I had to sit with a colleague at lunch and she had the most lovely Cara Orange last week. It was hard. But there is a lesson there. Often in allergy screening they will look first to what you CRAVE. That is what you should eliminate first for the experiment. Onions too, were a huge staple in my cooking. So I have had to make changes.

I don't know if 6 weeks is enough. So I can't answer that. Sorry

Mtx
 

I've done a google search on low-dose methotrexate, and there are reports of death from bone marrow suppression. This is probably why I've said no in the past. Each time the doctor recommends it, I think I google it, find that some people have died, and tell myself: I'm not going to die from having pain, so it's not worth the risk. However small it is.

Continuing the discussion of possible fatal drug effects
 

LizaJane,

I can't think of many medicines without some fatal risk. The new January Discover Magazine has a chilling article in "Vital Signs" about a poor woman who died from pseudomembranous colitis caused by a short course of the antibiotic Clindamycin. The article points out that many antibiotics including the penicillins carry this risk, as does acid reducing medication (I take Aciphex daily).

The author is Dr. Tony Dajer, Interim Chief of ER Medicine at New York Downtown Hospital.

I have questions about your Methotrexate concerns. Is the bone marrow supression asymptomatic? Can it be detected through testing before it progresses to dangerous levels? If so, is that testing normal procedure? Is the bone marrow supression reversable if caught early and the Methotrexate stopped?

Methotrexate side effects.
 

I just looked up the Warnings and Precautions section for Methotrexate at www.rxlist.com ( http://www.rxlist.com/cgi/generic/mtx_wcp.htm ). That is serious and scary stuff. If I were in your situation, I think I'd also not take Methotrexate for other than seriously debilitating or life threatening conditions.

It seems wise to me to look up and understand the side effects and risks of every drug one takes to weigh risks vrs. benefits. Negative consequences are far more serious for us patients than for the prescribing physician.

David--
 

Exactly! My doctor hasn't seen any fatalities, and he's very gung-ho about this med. He's sure that close monitoring will keep me from developing anything serious. But in articles I've read, there was a series of 35 deaths from this. Were all those patients poorly followed?

Also, he didn't explain to me the risks or drug interactions at all, leaving me to look them up. I'm having a better week this week, and am in a clearer state of mind when I'm in less pain. So I figured I'd just say no.

But I have begun Lyrica, 50mg. Can't say anything one way or the other yet. One thing that has helped---the radiologist says he thinks the sciatic type pain is due to scar tissue, so I've been assiduously self-massaging along my spine and butt each night, and you know? it's really helped!

LizaJane
 

Was that cadaver bone or your own?

My friend here and I both have had trigger point injections along the spine, which has helped with pain and inflammation considerably. I have tried to hold back on these a lot, because they contain cortisol (Ketamine and maybe something else???) and I am already on Prednisone, which is not good on the bones and probably not good there around the joints, I would suspect.

Meanwhile, my friend has had BUNCHES of them and she is going to have to have some kind of fusion next month...

Cathie

P. S. I thought you had to be really careful on Diflucan, because of its effect on liver. Is someone monitoring enzymes?

LizaJane
 

Was that cadaver bone or your own?

My friend here and I both have had trigger point injections along the spine, which has helped with pain and inflammation considerably. I have tried to hold back on these a lot, because they contain cortisol (Ketamine and maybe something else???) and I am already on Prednisone, which is not good on the bones and probably not too good there around the joints, I would suspect.

Meanwhile, my friend has had BUNCHES of them and she is going to have to have some kind of fusion next month...

Cathie