Second Surgeon Visit

[jsewell]

I saw my surgeon, i am now 4 weeks out of surgery. We discussed the possibility of fusing the lumbar area from the back again., We still have time to wait on that decision,. Apparently he said he would not do this operation on his wife, mother, sister etc. If their spine were in my shape. My bones are so weak when he did the surgery from the front the cages are subsiding into the vertebrae. so they are not holding the space open as they should have instead they are kind of just sinking into the vertabrae. He is afraid if he tries to go in to the back , as he did last year that the screws will cause more fractures every time he tries to use one, I currently have 4 good sized fractures in my lumbar spine. so i suggested spinal cement., He thought that was a good idea and when i see him in one month if i am still in this amount of pain , that is what we will do.
Do you think i should be concerned that i came up with the idea?

On to the drop foot, no improvement. I am open to any suggestions. It is too early to have an EMG, but again when i see him in one month it will be ok so we will schedule it then. He said it does come from the L5 area and last year when i had the EMG it showed problems in that nerve. It showed current inflammation as well as damage. I just hope this can be fixed. He said maybe it isn't even a never spine problem. Maybe a tendon.
Which i have been wondering,even when i was in the hospital. I had a call on the friday before surgery that i had a urinary tract infection. It was a rush to get meds into me as surgery was on monday morning so i was told that the prescription was called into my pharmacy. that was a joke in itself as my small town phramacy was closing in 15minutes and i live about 15 minutes away and then need to park and gimp to the store. so Rei from my doctors office called the pharmacist and i am a good customer so he agreed to wait for me. anyway the drug was cipro, one of the ones Maria had posted the warning about. so did it cause a tendon rupture without lots of pain? I did ask the primary doc that was following me in the hospital and he said he didn't think so because it would have been so painful. So i am on hold on the foot drop.

I am no longer on bed rest, i am not supposed to do much, and when i mentioned housework, he just didn't say much but to ask aboiut my kids and how they were doing, so i will do little bits and take many breaks. I am still spending a fair amount of time in bed. Yesterday i needed to go to the bank and the pharmacy and it did hurt so i am not going to stay out that long again. oh and target.
WEll sorry that was a book, that is what happens when you are in bed most of the day!!!!
judy

[Maria]

Hey Judy,
I had wondered about doing spine surgery on someone such as myself with moderate osteoporosis (that was at the last DEXA scan). I didn't think it would be a good idea for myself and since my 2nd spine surgery failure I have been extremely cautious with regard to the idea of more surgery. Then again if it's necessary then one must do what one must do.

I would wonder why your surgeon didn't think of the cement for fractures before you did. He sounds very reluctant to go back in and do more surgery on you esp. if he states what he did with regard to not wanting to do this type of surgery on his wife, mother or sister if they were in your shoes. I always ask that question to see what the surgeon says.

Anyway it's good that you're able to be up and about more though do be careful. I know when my Dad had his spinal fractures and he had only 2 I believe he was very limited in what he could do with regard to the pain. I felt so bad for him because as old as he was (87 then I believe) he'd never experienced pain like that before except when he had kidney stones and he was just miserable. The fractures did heal within about 2 months I think but he also didn't have any hardware in his back but he did have EXTREME DDD thru out his spine and severe osteoporosis.

Oh with regard to the tendon thing.. I had SUPER SEVERE pain with my posterior tibial tendons bilaterally at the same time! I could not put my feet on the ground even at first and crawled to the bathroom. I mean it was horrible for about 2-4 weeks the first episode. Now it's freaking chronic and I hate this stuff but I do not have footdrop. I had that starting before I had my L5S1 discectomy done.

Ok wishing you the best and hoping the foot drop will recover and the pain will subside as the fractures hopefully heal. If not the cement sounds like a good idea to me if there aren't some serious risks involved.

take care and good to hear from you~ Maria

[mmglobal]

Judy,

Regarding your fractures, I believe that kyphoplasty is commonly used to stabilize burst fractures that occur in older and osterporotic patients. It seems like a reasonable idea to use it in your case. I do NOT know what to think about the idea that you thought of it first. It seems a pretty benign question, "why didn't you suggest it first". I'll be interested to hear his reply.

Mark

[jsewell]

Yes, i have had kyphoplasty before in my thoracic spine by this surgeon. I think he is just overwhelmed by my case. He did tell me months ago that i have been his most difficult case.
These 4 weeks cannot go by fast enough. I want to kyphoplasty to feel better. I want the EMg to find out where the drop foot is coming from and get the darn think hopefully fixed. I am not a patient person when it comes to my health!!!
judy

[mmglobal]

Judy,

What was your experience with kyphoplasty? I've heard that it can yield immediate and complete relief. (obviously, it can only relieve the pain associated with the fracture that it stabilizes.)

Mark

[Maria]

I figured your surgeon might have just been rather overwhelmed to even suggest anything else re your spine. I hope if you're not healed by the next visit and you do get scheduled for kyphoplasty it will help and immediately.
How's it done, what's the experience like getting it?? Please describe.

really YOU impatient?? Who woulda thought?!

[jsewell]

Mark and Maria,
Kyphoplasty was like a picnic for me when i had it. It was on T2 and T3. Many surgeries ago. It is a small incision they insert a balloon, blow it up and fill it with bone cement. So you regain some lost height, boy do i need that now. Then maybe closed with a stitch or some glue. Then my surgeon has an overnight stay in the hospital. then you go home, no pain , and you are pain free in that area.
I really don't know how much of my pain is from fractures at this point, but my surgeon thinks quite a bit is so i am looking forward to a night away. I hope he still does that and has not joined the majority of surgeons at Huntington who make this an outpatient procedure. I will ask at my appointment. Hay it is almost 3 weeks now, not 4!!! I can make it i know i can.
judy

[Maria]

Ok so this is for anybody that knows ... Judy, Mark..??

From point of diagnosis of fracture how long does a surgeon or doctor usually wait to do kyphoplasty? My father wasn't offered this but I thought it might have been his advanced age. I'm just wondering since I have osteoporosis.

Also when you have a spinal fracture is the pain easily discerned from other type of pain like disc related pain?

It sounds like a pretty quick and easy fix. What re the parameters for use? What are the exclusions for getting kyphoplasty?

[mmglobal]

Maria, sorry, but I just don't know. Judy, did they knock you out? General anesthesia may not be OK for someone really old or frail. I think that bone is very highly innervated, so I would expect an unstable fracture to be much more painful on movement or weight bearing than a disc issue.

Mark

[jsewell]

In my case it was general anesthesia, but my spine surgeron uses that for ESI's as well so it may just be him and not liking to see people in any pain. I really cannot speak as to the age of people or the health of those who get this procedure offered. As i stated i have no idea which pain is coming from the 4 fractures and which could be coming from a disc problem. He did remover 3 discs during my last surgery so i would assume my fractures are the cause of my pain at this point. My pain is greater than it was before this last surgery.

I just spoke with my surgeron last night as my weight has gone up 14 pounds in less than a week since i had seen him. Possibly the gabapentin , he told me to stop that and he is prescribing lasix which i have to go pick up. also my return of my fecal incontinence. Started last monday was with me for a few days, went away and started again this monday. Saw my pain management doc yesterday and he said the incontinence would be from the lower nerves such as L5 or sagittal area so i told my spine doc about this return and i have an MRI set up for the 26th . I guess i have got over my embarrassement of speaking to docs about this new subject. I would just hate the thought of this becoming permanent. Maybe it was the powers that be telling me that foot drop on a permanent baisis would not be as terrible as i made it sound last week!!! Or at least as the expression on my face must have made it seem.
Well i will update soon on my various problems. who would have thought a back ache could lead to so much!!!!
Judy

[Maria]

Hey Judy,
sorry to read about this. Do you have cauda equina going on by any chance? I'm wondering why the MRI isn't being done sooner given the fact that you're reporting fecal incontinence. One the things I was always told after spine surgery or with spinal insult/injury is to report incontinence of bowel and bladder immediately for the window period of recovery.

To me footdrop as long as I can manage walking with that extremity would also not be as upsetting as the fecal or urinary incontinence. I too hope in your case or anybody's for that matter that it's not going to be a permanent thing.

Yeah spine related stuff is just such a royal ass pain literally and then pain isn't even the worst of it although it just is really really rotten to live to have deal with at any age!

Wishing you the best and hope things can be worked out to stop the incontinence prob ASAP (tho I still think addressing it ASAP might help).

[jsewell]

Maria,
I have no idea what i have going on. My pain management doc said the lower levels would be the ones involved in the incontinence issue,the sacral levels. Anyway my spine doc told me to get an MRI as soon as possible and the imaging place at the hospital's first opening is next Sat the 26th, i believe then i will see him on Monday.
I had another problem this past week and spent 9 hours in the ER. I was gaining more and more weight , already had 2 doctors telling me to discontinue a few meds that could have been causing the problems. But when i was going to the pharmacy to get my diuretic i was so short of breath, worse than running a marathon, i stopped at a bench and called my primary who told me to og to the ER. Well they were looking for a blood clot as i had all the symptoms. They did an ultrasound of the legs and a ct with contrast of the chest , but fortunately no clot. So at 3am a doc told me i could go home if i felt ok. Well who feels ok at 3am. so i called my overly tired son and then the nurse came in to discharge me with the paperwork and proceeds to tell me i have pneumonia (the doc and i argued about that one) and congestive heart failure. the doc never mentioned the heart failure thing. So i have been a wreck. It was based on my shortness of breath, high blood pressure at the time, swelling in legs and feet , and who knows what else, oh a lab value for bnp.
My daughter came home (the one in nursing school) last night and we talked it all out and she calmed me down. I have an apt at my primary's office on Monday too. Life just stays too exciting for me .
The doc was basing the pneumonia on imaging showing atalectasis (but mine is old from my injury with DrRegan) but he just said you might have it so he prescribed antibiotics, they kind of made me take a dose there, but i did not fill the prescription, I have had pneumonia several times and know i did not have it. Oh by the time i left my bp was back to normal from pretty high. My daughter said it would be high with all the extra fluid. They should have told me that one too. Oh well it messed me up because i missed a whole night or 2 of sleep, but back to whatever is normal for me now.
My spine doc was nice enough to check up on me after my Er visit, he really is a keeper.
Update later as more develops !!
Judy

[Maria]

First thing I thought of reading about your degree of SOB was CHF and pulmonary edema possibly secondary to pneumonia. That's a pretty common cause tho in your case with various medical conditions and types of meds the list of things to rule out increases. So glad to read no clot found. Glad to read you have a concerned spine doc. He probably hates to hear or think of you going thru anything else!!!!

Pleasè keep me posted on how you progress with everything

[theBadCormorant]

Originally Posted by Maria

First thing I thought of reading about your degree of SOB was CHF and .....

Could we have a list somewhere with all the acronyms
Shortness of breath ?
Swiss Francs ?


Judy - you sound so positive considering the horrors you are going through - well done you, and best of luck.

[jsewell]

I'd rather go with Swiss Francs, but the CHR is congestive heart failure, the nurse had a hard time telling me who 5 years ago was running up the mountains of southern California that the diagnosis was for me.
I do have lung damage from a surgery on my thoracic spine done a few years ago and i think the old scarring is what gave me the pneumonia diagnosis. Also contributes to the shortness of breath, but this time it was really horrible. Nothing i had ever experienced before.
I do try to have a good attitude , but it is getting more and more difficult, let me tell you.
judy

[Maria]

Your attitude is admirable Judy really. I am not quite that well balanced!

Hope you're continuing to feel better and I'll send you an email later on today to catch you up with my "stuff"~ take care! Maria