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Thread: what can I do?

  1. #91

    Unhappy bad news

    Dr Wise - SCI nurse - Anyone!

    I got the report from my last MRI after falling there's a Schmorl's node within the inferior T10 endplate, a loss of intervertebral disk space & height and T2 signal at several levels.
    "Impression:
    1. Multilevel moderate broad-based central disk protrusion with contact of the ventral spinal cord at the T6-T7 through T8-T9 levels.
    2. L4-L5 broad-based central disk protrusion displacing the L5 nerve root and moderat paracentral disk protrusion touching the riht S1 nerve root.
    3. At L4-L5 there is a diffuse disk bulge with a superimposed broad-based central posterior disk protrusion, asymetric to the left that measures aproximately 6 x 14mm (AP, lateral dimensions).There is dorsal displacement of the L5 nerve root and S1 nerve root."
    Ok, so what now? Is all that why the pain has become so severe if I try to stand/crutch walk just a few feet? It it why I can't sleep for the pain? Why I can't sit, stand, lay down without pain? What, besides not falling, can I do until I see the surgeon? I see my PCP on 9/9 & the surgeon on 9/11. I'm frightened. Haven't heard from the VA yet.
    Last edited by Coleen; 08-27-2009 at 11:48 AM. Reason: spelling

  2. #92
    Any answers would be appreciated, thanks

  3. #93

    Unhappy Guess I'll plat it by ear

    Guess I'll just have to wait & see what the surgeon says.

  4. #94
    Quote Originally Posted by Rev Coleen View Post
    Dr Wise - SCI nurse - Anyone!

    I got the report from my last MRI after falling there's a Schmorl's node within the inferior T10 endplate, a loss of intervertebral disk space & height and T2 signal at several levels.
    "Impression:
    1. Multilevel moderate broad-based central disk protrusion with contact of the ventral spinal cord at the T6-T7 through T8-T9 levels.
    2. L4-L5 broad-based central disk protrusion displacing the L5 nerve root and moderat paracentral disk protrusion touching the riht S1 nerve root.
    3. At L4-L5 there is a diffuse disk bulge with a superimposed broad-based central posterior disk protrusion, asymetric to the left that measures aproximately 6 x 14mm (AP, lateral dimensions).There is dorsal displacement of the L5 nerve root and S1 nerve root."
    Ok, so what now? Is all that why the pain has become so severe if I try to stand/crutch walk just a few feet? It it why I can't sleep for the pain? Why I can't sit, stand, lay down without pain? What, besides not falling, can I do until I see the surgeon? I see my PCP on 9/9 & the surgeon on 9/11. I'm frightened. Haven't heard from the VA yet.
    Rev Colleen,

    Let me start by describing how a surgeon would look at the MRI because it is very different from the way that you would look at it. The surgeon looks at the MRI to see whether there is anything that can be surgically corrected and that may relieve the symptoms being described by the patient. If there is nothing that can be clearly fixed by surgery, the surgeon will not operate. Many surgeons are also reluctant to operate just for pain alone because the surgery often does not relieve pain. Finally, most surgeons are reluctant to operate on spines where there is multiple degenerative areas because he/she will not be able to do multi-level disc removal. What surgeons love are single disc protrusions that are clearly compressing the spinal cord or root and there are clear neurological symptoms that correspond to that compression. Those are the cases where he/she will get the best results.

    Now, from that perspective, your MRI shows that you have multiple disc protrusions at T6/7, T8/9, and L4/5. Your thoracic discs are touching but do not seem to be pressing on your spinal cord or roots. Your L4/5 involves multiple levels, including the L4, L5, and S1 roots. You have neurological symptoms that seem to match the L4/5 disc herniation. I think that most surgeons would want to operate on L4/5.

    Regarding what you should do, you need to avoid stress on your lower back as much as possible. But, your spine is already telling you that and screams with pain every time you try to do something. Please do understand that there is no spinal cord at L4/5. The spinal cord ends at L1. What fills the spinal canal below L1 are the spinal roots that form the cauda equina. The herniated disc is displacing spinal roots. Removal of that disc may reduce that displacement but that may not be the cause of your pain.

    Given your multilevel disc problems, you should be careful about doing too much surgery, particularly fusions of spinal segments. Every time there is surgery that includes fusion, this tends tends to reduce the flexibility of the spine and this puts more stress of the remaining segments, accelerating degeneration of your spine. So, it would be better to have a procedure called microdiscetomy to remove that disc without fusion, if possible. Remember that surgery often will not improve pain.

    Wise.

    Wise.

    Wise.

  5. #95
    Thank you. At the strong suggestion of the ER doctor, (and intense pain if I try to walk) I'm using my w/c most of the time now. You're right about my back screaming in pain whenever I try to move very much. Twisting motions are totally out, bending motions are out, too, except to sit. My understanding is that the longer the caudia equina bundle is 'pinched' the less chance there is for 'recovery', hence the pain doesn't go away, and I'm prepared (but not liking it) for that situation. I'm frightened about the cord being 'touched' - will that 'heal' or possible just get worse? Is walking going to be any more of a problem than it already is? Thanks for your reply (or anyone elses) in advance. Still frightened, though.
    Coleen
    Last edited by Coleen; 08-30-2009 at 01:18 PM. Reason: spelling

  6. #96
    Well, somehow in my (finally got some!) sleep I managed to make my back a little worse - now my right leg is pins & needles! Doesn't really hurt, just a slight ache, the left is almost intolerable. Oh well, must've turned wrong or something - I woke on my stomache & in pain. Oops!
    Talked to my counselor today about being scared, she said that was a good thing - it'll help me to "behave" & not do anything stupid - she's right. Ugh.

  7. #97
    I'm becoming more depressed than usual - fell again & nearly pulled a 500 pound scooter (my Mom's - Dad loaned it to me) over on top of me off my ramp - more severe pain & now my right leg is tingling too - I can still feel in it, but the tingle won't go away. My son & brother widened the ramp, so I can get it in & out now, but my PCP is holding up me getting a proper sized hover-round scooter - whe's the one who wants me to walk - right. Like I can take more than a couple of steps unaided & without intense, severe pain & falling. No wonder I' more depressed! I see her tomorrow, maybe for the last time, see the surgeon on Friday & the VA on 10/13, so one of them might be able to do something - the cat 5 VA doesn't cover DME's, glasses, hearing aides or dentiures at cat 5. My kids are keeping me alive right now. My counselor's out of town until the 17th - figures.

  8. #98
    Saw the surgeon - said the damage isn't bad enough yet to fix. He sent me to a neurologist, who is doing another EMG & an EEG, and is sending me to another surgeon for a second opinion - he feels that if the disks were repaired & the nerve bundle was 'released' I'd get 75 - 80% improvment. He also said that my neruopthy from type 2 diabetes that I have in my feet is adding to my issues. I failed the other EMG, but he said that it may have gotten worse. duh! Hey, at least someone besides the SCI group believes I'm having problems!

  9. #99
    Had the second EMG & the first EEG yesterday - next neuro appointment in 2 weeks - I see the VA 2 days before that. Right leg is involved now. AHHH!!!

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