I do care. All this stuff to do with the back issues are hard to deal with. I will be thinking of you when you go for your next appt. on tuesday. Go armed with as much information as you can gather. I sooooo hope that there can be a good resolution for you. I hope this weekend you can have peace in your life as you wait for your appt. Let me know how it goes. ginnie

Ger, was right. The opinion from the neurologist, or neurosurgeon should indeed be on top of the list. I was mearly stating that it is OK to go to a pain specialist for another opinion in addition to the nerurologist. Maybe outside that particular facility. I had been in with a PCP for the six years, never realizing I had deterioated, and he didn't question it. I went to the pain specialist as "I Knew" I was getting worse, and had been told before all that could be done was corrected. I didn't think there was any hope of more surgery to help me. I would have sought out a neuro surgeon first had I thought there could be help. So this pain doc. did indeed rescue me, and sent me in the right direction. He gave me Katamine infusions while I waited for the surgery. This did not cause me any problems or pain, not even at injection site. The other epis were terrible. ginnie

My spinal fusion and laminectomy were performed at the same time. The surgeon said he had never seen such a "red angry nerve". Not sure the nerve root and my compression from the vertebrae crushing the nerve is the same. The surgeon did not realize how badly compressed the nerve until he was performing the surgery. Not sure, but things might have been much worse had I not had the surgery.

A couple of years before my surgery, I had also been to a doctor for my arthritis on my wrist and told him about my spine/leg/groin pain. He referred me to one of the doctors on their staff. They also have ortho/pain, etc. associated with their clinic as well. She did an MRI which showed spinal stenosis and degenerative disc disease and a problem with L4-5 but don't remember exactly whatelse was mentioned. She was a pain specialist. Did steroid injections and recommended physical therapy, which I did. (I get migraines from the steroids as well - inform you doctors of your problem.)

Eventually, the pain was almost unbearable. I tried to get an appointment with the ortho/spine specialist on staff; but he could see me for a couple of months. Pleaded; but still could not get in any sooner.

Because of this, I went to Rush Medical Center and had the fusion/laminectomy there. A couple of years later, did get to see the original doctor I had wanted in the first place. Both he and the surgeon felt further surgery would not help me as there were other problems as well so I should expect to have some continued pain.

Along with my spinal issues, did develope Pheiphereal Neuropathy. The burning feet, ankles, and leg pain is almost as bad as the spine pain. I am dealing with a few issues. Therefore, was given a name (someone else than from their clinic) of a Pain Specialist who I have been under his care for close to 3 years.

My only concern in your case is that they do not send you to one of their pain specialist first. Your second opinion should be from their spine/ortho. Like I mentioned, the clinic I first went to had a complete line of all these doctors as well. Just be sure your appointment is with a neuro or ortho/spine doctor.

Hope all turns out to be the best road for you to take. In the meantime, try to relax and have an enjoyable Christmas.
Ger

I had a L3-L5 laminectomy and it did the trick. Back pain is history but the peripheral Neuropathy remains.

Hey Newbie;
I had a L3-L5 laminectomy and that took care of 35 years of back pain but left my legs still in pain. I have burning on my left and numbness on my right. Because of damaged as well as dead nerve cells I will never be pain free. So I will tell you something invaluable: You need to take maximum amounts of your medications. Half measures avail you nothing. Check with your Physician of course but Medications for neuropathy other than narcotics are of little use. But we do not want to take narcotics so there is Lyrica. Forget neurontin unless you take in conjunction with Lyrica. Just a little friendly advice.

RX Horatio, thanks for the info on Lyrica. The 1st Dr. I saw - the ortho surgeon - put me on Gabapentin (Neurotin) so the 2nd dr. (the PS) continued with gabapentin but doubled the daily dosage, which controls the nerve spasms- somewhat. I personally do not want to increase medication UNLESS I HAVE to...start with minimum because an increase may be absolutely necessary in the future. From what I've read, gabapetin is not a scheduled drug but Lyrica is. The PS or neursurgeon may change the gabapetin to Lyrica or something else anyway, because I am getting swelling in my hands and that can be a side effect of gabapetin. Glad your laminectomy was beneficial to you! - and thanks for your input! I too am concerned about pemanent nerve damage in my buttocks, legs, feet, as I have had the spasms, which increase in number and intensity on a weekly basis, for so long and the dr.'s appointments are always at least weeks apart.

Hi Seahorse,

I agree with this for the same reason and another - that we should always take the least amount of anything required to acheive the desired results. Dosages are usually determined/recommended by the pharmaceutical companies based on averages derived from their studies/trials. Doctors tend to follow these guidelines unless they have experience/reason not to. But this also means "one-size-fits-all" medicine, and since we're all different, those guidelines are going to be too much for some and too little for others (which is my main argument for titrating from lower to higher).

The deal with gabapentin & Lyrica, as I understand it, is this: Gabapentin is an older medication now out of patent (generic). It is often used as a firstline treatment for PN and other neuropathic pain because it sometimes works (despite side effects), and because it is generic, it's cheap.

Lyrica is similar to gabapentin in several ways (some say an improvement on or improved form of - I'm not a chemist/pharmacologist), and ostensibly has (generally) less/fewer side effects, but it is still under patent, therefore more expensive. Some insurance companies/policies will approve Lyrica right off, some will approve it only after gabapentin is tried (and sufficient reason shown for prescribing Lyrica instead) and some will just flat out refuse it.

I have no bias/preference between the two - whatever works - but if cost is an issue, I think I'd give gabapentin a try.

I'm not sure (now) when Lyrica's patent is due to expire; one site says late next year ('13)
http://epilepsy.emedtv.com/lyrica/generic-lyrica.html
while another says '17 - '18
http://www.uspto.gov/patents/resources/terms/156.jsp
(2 patents near bottom of page)

I found this on the FDA's classification of Lyrica as a controlled substance.
http://www.mmm-online.com/setback-fo...article/22504/
This is the first I've heard of this, so I think it's worth pursuing further (factchecking on both patents and this controlled substance issue).

Google: lyrica patent expiration
Google: lyrica controlled substance

Doc

Dr. Smith - I've seen great MRI's turned into laymen's terms from you and others. Would you mind deciphering mine as well? please

Grade I degenerative subluxation at L4-5 with bulge, annular tear, prominent facet arthropathy. Mass effect on the right lateral recess nerve root w/crowding of the left. Stress injury of the pedicle & pars region of L5.

Monday from.....well ya'll know from where.
Got to the pain clinic, nurse got the i.v. needle she was putting in my hand hung up in her latex glove somehow (I didn't see as I was talking to the dr.), pulled it out of my hand youch!!, bled like crazy, popped up the size of a walnut, which she put pressure on, aaaarrrggh the pain! Errrr, shall we say not a good start? Wrapped my hand in ice. Put another iv in my arm - success this time! Due to lots of drug reactions/allergies, doc decided to use fentanyl at 1/2 dosage as anesthesia and 1/2 dosage of epidural steroid. Klonopin script written up to counter my usual reaction to steroids. Injected right lower lumbar. Went smoothly. Couldn't put any weight on my right foot going up steps when I got home, tho hours later the right side felt much better, but made me sooo much more aware of how badly the left side feels. As I've whined before, both PS and previous OS said that they did not think epidurals would do any good in this case anyway, but at least when I see the neurosurgeon in a couple of weeks he will see that I've already tried this. Permanent nerve damage a concern for the pain specialist doc, and for me as well. Said to take it easy for a few days, and just do things as I feel I can, nevermind what I WANT to do (see I'm one those hyper, irritatingly busy sorts - if I'm awake I'm in motion). I will call the neurosurgeon's office daily between now and my scheduled appointment to see if they can pop me into any cancellation spots they may have. Time goes by so fast UNLESS one is in pain doesn't it?!

Umm... your lower back is really messed up and hurts like cuss?

Seriously, I'm flattered, but I think it must have been someone else, and there are several people here who are much more knowledgable/experienced than me (I?); I'll have to look most of those terms up myself, but I'll take a stab at it and defer to others' corrections/different interpretations.

I think you know what degenerative means; it's deteriorating, and will continue to get progressively worse over time. This progression may be the natural result of aging; very slow (taking years to decades), and some natural healing may occur in the interim as the body tries to protect itself.

From: http://www.spine-health.com/conditio...ndylolisthesis
From: http://www.arachnoiditis.info/conten...listhesis.html
I would think that traumatic injury would be an exception to the above.

Paraphrased from: http://en.wikipedia.org/wiki/Subluxation
Subluxation implies the presence of an incomplete or partial dislocation of (in this case) a joint. A spinal subluxation is relatively rare, but can sometimes impinge on spinal nerve roots, causing symptoms in the areas served by those roots. In the spine, such a displacement may be caused by a fracture, spondylolisthesis or severe osteoarthritis.

From: http://www.mdguidelines.com/spondylolisthesis
Since we're talking about the joint between L4-L5, the bulge and annular tear are in the disk. A bulge is just that.
From: http://www.laserspineinstitute.com/b...ular_tear/def/
*(I have this type of annular tear at L5-S1)

The facet joints are the joints of the spinal column - between the vertebrae. Facet arthropathy essentially means arthritis of the facet joints. I believe prominent in this context means severe (subject to correction).

I'll need some help (or much more time) on the rest of it. Your doctor should be able to decipher and explain all this. Be firm and perseverent until you get satisfactory answers.

HTH,

Doc