Next step after surgery
 

As you all know my recovery is not 100%. What happens once the surgeon or the patient come to the conclusion they have reached the maximum improvement from the surgeries but the patient still has pain?

Do we go to pain management? I guess I'm trying to figure out who I would see once the surgeon releases me.

If you are not certain of any return to work date, might be time to file for SSDI while surgeon is on board.
If you think it will more than a year before returning to work SSDI is worth trying.
You might be able to set date back to when off of work started.

More details on our SSDI forum & the stickys there.

And pain management if your primary dr doesn't do that sort of thing..

The LTD company will probably ask me to apply for SSDI soon anyways as I have been off almost 9 months now. I don't know when I will be able to return. The pain is still a major issue.

Jo, I can't remember if you ended up going back to work. If you did, what kind of work are you doing now?

No didn't go back to a job , it works for us.
I don't think I had specific nerve or vascular TOS - mostly minor sx of both so I think it goes under disputed TOS with long term repetitive multiple injury /strains and the work postures involved.

But I am able to do most activities without too much increase in pain, more of discomfort for me.
I'm probably more at a mild chronic myofascial pain status now, more than TOS/RSI.

Aleve at times , more so in cool/wet gloomy weather and heating pad & IF stim take care of most aches after extra activities.
*my fine finger coordination /typing makes for the most irritation now, glad I have the spell checker...*
I am part time care giving for parents ,just started doing that.

Now my L5 is the more problematic it slips around and gives some sciatic issues at times..:(

Ugh, back problems really suck. I guess pain management would be the next step although I don't want to be pumped with medications. My pain increases with sustained activity, if I don't do much it is very reasonable.

Did PTs ever try IF stim on you? Interferential stimulation - like TENS but better IMO...
If your pain is around your neck, shoulders & upper back it might be worth a try to see if it helps.

Never tried it but I will look into it. My pain is def in those areas, as well as forearm, wrist and fingers.

Hi, Nelly. I have a TENS, and it is helpful. I was diagnosed with Complex Regional Pain Syndrome now and was given Memantine to try to help with the ongoing nerve pain. I think it is being used to try to "reset" things. I'm also taking:

Provigil - 200 mg (morning and noon)
Keppra - 1000 mg 3x daily
Tegretal - 200 mg 3x daily
Soma - 350 mg 4x daily

and some other things...haha, but these are the main ones to help with pain

How are you handling the side effects from all these medications? Soma made me end up at urgent care, I don't do well with medications.

Is the CRPS a result of your surgery with Dr Donahue? Did it develop after surgery? Also, were you on all these pain meds prior to surgery w/Dr Donahue?

Dr. Donahue is a great surgeon. I think they just like to give me a new diagnosis every time I go to the doctor. The nerve pain isn't much different than before surgery as far as level of nerve pain, it has changed location a little bit....really the big thing is that I'm not trying to work 8 hours a day typing like I was before surgery, so it is hard to compare.

The pain in my shoulders is soooo much better, specifically the traps. I had TOS for 12 years before getting surgery, so my nerve pain is more from the brachial plexus being compressed for sooo long. I should had surgery 10 years ago in retrospect, but it is what it is. I really do think Dr. Donahue is an excellent surgeon, I'm a difficult case, but now I can start to heal...regenerate nerve and grow back 12 years of wasted muscles.

Closer to right after my surgeries my nerve pain was a lot worse, the Mematine XR is helping a lot with the nerve pain. My dosages are now:

Mematine XR 28 mg a day
Keppra 2500 mg 4 times a day (this is a crazy high dose)
Tegretol 200 mg 2x a day (had to cut back because it was making my lips and tounge go numb)
Soma - up to 350 mg 4 times a day


Dextromethorphan - up to 60 mg up to twice a day - this is robotussin and OTC, really does help with pain...and makes the clouds so pretty at times, lol.

I'm doing yoga, walking, and the warm water pool for exercise - gotta love the warm water pool.

Also, had a disability hearing last week and was told I would be approved....the TOS ALONG WITH the "cognative impairment" from all of my medications was a deciding factor. I went to a neuropsychologist for a neuropsych eval, they determined my pain and medications made it too difficult for me to work....my processing speed/performance IQ was very low compared to my verbal IQ - a difference of around 30 points, apparently, all of the anti-seizure/neuropathic pain medication slows the mind down....and since I'm on a lot of it, it's really slowing me down. Anyway, I'm happy I was approved for the disability, but it was seriously depressing to hear the government worker testify that there was not any kind of work in the United States I was capable of doing.

I didnt know you had shoulder pain as well. Was it over the traps, and upper traps area?