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Thread: what can I do?

  1. #11
    Quote Originally Posted by Rev Coleen View Post
    I believe the coccyx was the injection site - really low down where the tailbone starts. It's the "right aspect of the L-2 vertibral body extending to the right pedicle..."
    L stands for lumbar, so your injection was done at the L2-3 space? That is at the tip of the spinal cord where the cauda equina starts. It is right about your waist line, not at your tailbone.

    I seem to have to uninate all the time.
    Which is why you need to see a urologist as soon as possible and get evaluated for a neurogenic bladder with urodynamics and a residual urine test.

    And how big is the spinal canal supposed to be? Mine is 11mm at one point, 9mm at another & 6 at another.
    The width of the spinal cord varies according to the segment of the cord you are describing.

    The doctor doing the injections does just that now, it's her practice, and I don't know what any other speciality she has is.
    You are seeing a physician and letting them treat you without knowing what their board certification is in? This is foolish. You should call the office first thing Monday morning and find out. Don't get more injections until you find this out, and I would still want a second opinion if the injections are not helping. If she is not an anesthesiologist, a physiatrist, a neurologist, or a neurosurgeon, you need to see one of those specialists.

    My PCP is the one 'in charge' of all of this - she's a ARNP & I've known her for 16 years. She was wrong about my neck, though, and had a back surgery herslf with some kind of not good complications - I think she might be afraid of the same for me.
    I am an advanced practice nurse too, and managing this type of problem all by herself without referring you to expert physicians is not appropriate practice for a nurse practitioner. Ask her to refer you to the specialists above, plus a urologist. NOW.

    Surgical treatment may not change your pain...in fact it is possible that treatment would make it worse. The goal of treatment should be to prevent any further neurologic deterioration. If you act quickly, it may not be too late to regain your bowel and bladder function. If it is too late, interventions should be taken if appropriate to keep them from getting worse (and yes, that is possible).

    (KLD)

  2. #12
    Quote Originally Posted by SCI-Nurse View Post
    First, you need to see this doctor again and don't leave their office until they explain this to your satisfaction, in language you can understand, with diagrams, etc. Is this a neurologist or what is their specialty?

    Then you need to request a referral to a good neurosurgeon for an evaluation to see if anything can be done surgically (and if your doctor is already a neurosurgeon, to someone else for a second opinion) and then to a physiatrist and a good neurologic urologist.

    (KLD)
    That's good advice. Consult with a neurologist and get a referral to a neurosurgeon to see what your options are. Please don't wait. Waiting can cause permanent damage.
    Daniel

  3. #13
    Rev, I don't know why you are getting all huffy. You need to read, and learn about your body and condition. If you don't take charge of the condition and your treatment, no one else will.

    Also, it is not considered cool to edit out your posts here after they have been responded to by others....

    (KLD)

  4. #14
    Sorry, didn't mean to be huffy, just gun shy. I also didn't relize I was editing a post or whatever. My bad.

  5. #15
    And no, the injection was way down & felt like under my tailbone. (where the 'crack' starts) I left the papers in my car & my kid cleaned it out for me, throwing pretty much everything away. Like I said, sorry.

  6. #16
    Found some papers - the doctor is an anesthesiologist. She did a 'caudal' "injection local anesthetic, contrat meduim and steroid" real low, as I said, where the 'crack' is. (sorry if that's rude, don't mean to be.) The injection helped a bit in my back, but hasn't done anything for my 'nerve pain' down my leg from my bottom to my heal & calf, hasn't helped with the weakness or need for a diaper, at post 5 days, now know when I need to urinate, although bowels still want to do their own thing, hence the diaper. Still can't stand/walk more than 10 - 15 minutes without 'losing' my leg to painfull numbness & weakness, although the weakness seems to be there all the time.
    And the 6mm space is at L4-L5 "at the L4-L5 disk space, a moderate sized broad-based posterocentral disk protrusion is noted. Mild bilateral facet changes noted. The AP dimension of the thecal sac measures 6 - 7mm representing moderate to severe spinal stenosis. Mild bilateral foraminal stenosis is noted. At the L5-S1 disk space, disc degeneration is noted with a small broad-based posterocentral disk protrusion Prominent epidural fat is noted. AP dimension of the spinal canal at this level measures 9mm." "A bony hemangioma is noted in the right aspect of the L2 vertebral body extending to the right pedicle."
    I've got no clue as to what all that means.
    Also, sorry about that posting thing, I'm new to this stuff & didn't realize there was a second page - computer stuff is still a bit of a mystery to me.
    Last edited by Coleen; 07-19-2009 at 09:25 AM. Reason: spelling

  7. #17
    You should go over the results of your MRI and current symptoms with your neurologist and consult neurosurgeon (to discuss surgical options) and also consult with a urologist who can do a urodynamics test or opther tests to see how much bladder function has been effected. You shouldn't wait.
    Daniel

  8. #18
    I'm (as usual) confused, if I now can 'feel' the need to urinate, but not stool, why see a urologist? I had a bladder sling 2+ years ago & it partly slipped, so I know my bladder is tipped. What I'm worried about is the bowel problem, and can that be fixed or is that a loss?
    Last edited by Coleen; 07-19-2009 at 10:12 AM. Reason: spelling

  9. #19
    You need to see the urologist to determine the degree and type of neurogenic bladder you have and how best to treat it. Improperly treated you are subject to urinary tract infections, and long term, even kidney damage. Fixing your bladder may not be possible, but there are methods for managing it to minimize risks as above and to keep yourself dry.

    The bowel control would be best obtained by working with an advanced practice nurse (NP or CNS) who specializes in rehabilitation or spinal cord injury, but this can be difficult to find. A physiatrist should also know how to help you with this. "Fixing" it may not be possible, but there are methods for managing it so you don't have bowel accidents, severe constipation or have to wear a diaper.

    Meanwhile, download and read this booklet. It is likely that you have a Lower Motor Neuron (LMN, areflexive) bowel, so focus on that information.

    http://www.pva.org/site/News2?page=NewsArticle&id=8095

    Follow up on seeing the other specialists mentioned above as well.

    (KLD)

  10. #20
    Thank you, and I'm working on taking your advice. Right now my insurance is messed up (again) so I have to work on getting it straightened out again first.
    The bike accident involved me, a squirrle & a softball sized rock, and I seriously doubt the squirrle is insurred, but my insurance wants their company to pay my medical - go figure.

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