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Thread: Caregiver becoming Careneeder!

  1. #1
    Senior Member
    Join Date
    Dec 2004
    Location
    Everwett WA
    Posts
    195

    Cool Caregiver becoming Careneeder!

    I hurt my back a few months ago (in July) holding Jake while Bob was doing bp--it's in a couple of areas between lower thoracic and lumbar. I've seen a few doctors, first because I hadn't gotten a pcp yet (now have one, an internist at a local clinic), then because he referred me to a physiatrist at the spine clinic because he (the internist) didn't know whether to have me get an MRI, see a neurologist, or what. He said the physiatrist could decide what to do.

    After CTs, Dexascan, and two X-rays, what I knew is confirmed, that I have osteoporosis in my lower spine and it's gotten more severe over the years, and that nothing else shows up to explain the excruciating pain I've had with this injury. (Except...um...osteoporosis doesn't hurt...so, what is this?)

    The internist prescribed Vicodin, twice a day, ice as needed, and sent me to the physiatrist.

    The physiatrist sent me to physical therapy first. This hurt me and I felt much worse. I stopped that, then he sent me to Hellerwork for myofacial release, massage, and synergy. The synergy hurt me something awful and I had to increase the Vicodin to four times a day for about two days, then back down to three, then two again. After 4-5 sessions (I was told it would take time to get used to it...), I quit synergy. Hellerwork feels good, so I get that once a week, and may increase it to 2x a week. Massage...well, I think I got further injury from this. The therapist laid her arm next to my spine and leaned into it--hard. I almost screamed, went home weak in the knees and near tears...again had to take 4 Vicodin a day and ice about every hour and a half. Now I'm trying to get by with 3x a day again, but not real successfully.

    This is actually the short version--the salient points. I've stopped massage and am planning to increase the Hellerwork, which is the only thing that so far hasn't re-injured me. My lower back is in screaming pain as soon as the Vicodin wears off, wakes me up, and I spend a good deal of my time trying to manage all this.

    The week before Jake's surgery, I went to see my internist again and asked if he would order an MRI, because he wants me to switch from Vicodin to Neurontin. I'm not feeling too comfortable about doing this without a more comprehensive diagnosis (the physiatrist thinks I have a muscle pinching a nerve; I think I have either some disc damage or spinal fractures.) The internist said that he's willing to have me get an MRI "to calm my anxiety". (Hmm...is that patronizing, or should he be curious about this diagnosis, too? And what is the insurance code for "this procedure is justified to calm patient's anxiety..."?)

    Meanwhile, the physiatrist had already tried to get me to try tricyclics and SSRIs and I said I wasn't confident enough about the diagnosis to risk the potential side-effects of these, and that I'd really like to at least consider the possibility that this might be a reparable injury. Or I'd like to know if I have any options beyond taking a pill for it, plus Hellerwork and ice.

    I've always been sensitive to meds, and usually will experience side-effects that are unpleasant enough to cause me to stop taking them at levels most would consider therapeutic. (Hence the favorable results of Vicodin 2-3x a day instead of the usual 'every 6 hours'.) (Except after one of those sumo-massages!)

    I am starting the once-a-month bone-building medicine, plus Calcium w/D.

    I am afraid to start taking Neurontin without knowing more. I do have some deferred pain with this, my side and stomach, but it is the pain in my vertebrae that wakes me up at night and takes the breath out of me. Is this the right direction for this injury...or should I look for more options?

    Thank you...Tana

  2. #2
    The MRI is a good idea but it also might not find anything treatable any way except through medication. Two or three doese of vicodin a day isn't a horrible approach. You might also want to try GENTLE massage administered when you are in a position that doesn't cause pain. Another idea is to try accupuncture which often helps a lot with pain. Neurontin is actually a fairly benign drug--the worst side-effect may be feeling drowsy. It might be useful for you to take something that is effective longer than vicodin, to smooth out the peaks and valleys of pain and suffering and relief.

    I'm sorry you are suffering so mich.

    RAB

  3. #3
    Senior Member
    Join Date
    Dec 2004
    Location
    Everwett WA
    Posts
    195
    Thank you, RAB. Benign is acceptable to me--I'll give my doctor a call and let him know I'll try the neurontin. Drowsy is OK, too, especially if I can get over it enough to help with Jake.

    Bob puts a little Tiger Balm along my lower spine in the evenings, and his touch is just about perfect, so I'll call that my gentle massage. Hellerwork is actually good and not too aggressive, and it stretches everything from my back to my ankles and wrists with no pummeling. Just no more Sumo Massage!

    Thanks again--I was having a hard time processing information about neurontin, and didn't know who else to ask. My doctors are both kind, but these days, they can only see you 15 minutes and don't have time to go into any real discussion or give a lot of thought to questions. I think they would if they had time, but working for a clinic, I think they're under pressure to move people through quickly. I'm wondering if an MRI would show disc injury and if there is any reasonable or safe surgical treatment for that. I don't want to have surgery any more than the next person, but would at least like to be able to consider it if it was an option, the percentages of success, etc., and be able to decide if I did or didn't want it.

  4. #4
    MRI would show disk problems. If this is the result of osteoporosis, compression fractures in the vertebral bodies may be the culprit. There are some surgical options for this but it gets chancy. I have a personal prejudice against back surgery myself--I've seen too many of the complications in my practice. But please feel free to ask any other questions that come to mind.

    RAB

  5. #5
    Senior Member
    Join Date
    Dec 2004
    Location
    Everwett WA
    Posts
    195
    I suspect fractures--maybe compression, but also maybe from an injury during that excessively heavy elbow-pressure during massage (having caused the most recent upsurge in pain--the original injury was most likely compression-caused from lifting Jake; I'd been somewhat better until this).

    I'm not in favor of surgery, either, and probably won't choose to do that, but if there is anything at all that I might do differently from or in addition to that which my docs have given me so far, I'd like to consider it. This is probably fairly straight-forward, so I'm not looking for a fairy-tale ending exactly, but besides the calcium/D, Boniva, myofascial release, ice, and neurontin (I start that tonight), maybe something will turn up, a therapy or supplement or suggestion from one of our nurses, that would only be theoretical if I didn't know my diagnosis for sure. I'm so motivated to be as functional as possible, 'cause we have such big plans for Jake. And I can't stand that Bob would have to do more than he does already because I was so out of commision.

    Thank you, RAB--this past two days feels like a logjam has started breaking up. You've helped me a lot, and Bob and I both appreciate your doing this.

    Tana

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