runner's surgery blog, L4/5, 2008

[Terry Allen Blackburn]

Runner;

My feet ached after my surgery. Right afterward, I would stay awake at night with my feet burning all night long. I had to wake up my poor sleeping wife and ask her to rub my feet. I slept with compression socks for awhile and that helped some. I had horrible cramps in my calves that would shoot me out of bed like a rocket. I was lucky I never killed myself flying out of bed the way I would. It felt like my leg muscles were going to pop through my legs. Horrible. The feet thing got resolved with massive doses of Lyrica. I was up to 400mg per day but have been off of that for well over one year. So feet and leg issues seem to be fairly common after these types of surgeries. I used to have planters fasciitis and had orthotics made for my shoes. Since my ADR surgery I have switched to wearing MBT shoes and have never had to use orthotics again. The Lyrica was a miracle drug for me and made all the difference in the world to my comfort level.

Terry Newton

[runner]

Terry,

I am on that other miracle drug, Gabapentin. I can really tell when it wears off. My left foot pain is minimal compared to the other pain. It is located right in front of the heel area and is just probably related to the nerve pain or is part of the nerve pain.
Yes, it feels like I have plantar fascitis in both feet, except the right one is enjoying the cortisone shot now.
Thank God, I haven't had those jump out of bed cramps for quite a while.
Saw pain doc, basically he thinks sciatica/numbness is definitely from L5/S1 and not L4/5. Disconcertingly, my patellar and ankle reflexes were almost nil. Waiting on what my surgeon says.
glad to hear you are feeling better and cracked up at that "let the force be with you" comment to Mark I just read.

[runner]

Saw neuro doc today.
X-rays of ProDisc at L4/5 look "fantastic"
I should be doing great he said.
He agreed with the pain doc.

runner
(but not running at the moment, should call myself, walker).

[Justin]

Originally Posted by runner

Saw neuro doc today.
X-rays of ProDisc at L4/5 look "fantastic"
I should be doing great he said.
He agreed with the pain doc that I should have a discogram to see if L5/S1 is a pain generator.
So discogram soon.

runner
(but not running at the moment, should call myself, walker).

Good news about L4/5 "Walker." Kimmers can you describe your pain--where you feel the pain in your leg/foot?

[runner]

Sure, I can take a stab at it Justin.
I don't have the same pain as I had with L4/5, which was a "take your breath away pain" at its worst and had surgery for 2008. But when I first "hurt" the other disc, I did feel that pain, where I almost dropped to my knees. It did stop me in my tracks, as I was doing Pilates and felt the pain, ignored it sort of, and then was walking with a stretch band on my ankles, felt it again, and had to stop (I felt this pain three times).
Exactly two weeks later, I woke up with sciatica, much more severe than I had with L4/5 and it increased until I called the doctor to request getting back on Gabapentin (I was off both narcotics and Gabapentin). At that point, I could not get off the couch without feeling serious hurt. I started on 900 mg of the drug as I was on before and then that wasn't enough and gradually increased it to 1800 mg.
The sciatica, which can be described as a knife-like pain in the glutes and hamstrings, is a 24/7 pain, which is muted by the Gabapentin. At the same time, i also had a resurgence of the plantar fascitis-like pain in my right foot. I have a history of plantar fascitis but it was mainly caused by working on hard floors and some running. When I didn't work or run, it was not there, but I tore my plantar fascia again in April 2007. Of course, I woke up with back pain in May and the plantar fascitis flared again and I was not working, not running and my podiatrist figured out it was related to sciatica (L4 nerve root). He also noted I had soreness where the nerve ran down to the foot. (I got cortisone shots, which helped)
Fast forward to post-op in August and I was off Gabapentin and narcotics and did not have a problem with plantar fascitis. It came back with the new back pain.
I also have had right toe pain, that woke me up at night and fairly recently intermittent pain in my toes on both feet. I have had pins and needles pain but not everyday and only in my feet.
Along with the sciatica, I have had numbness in my legs and feet. I have had my legs fall asleep (usually only one) when I am standing or laying down. My left foot regularly goes numb especially when driving and currently when sitting. When driving, my right foot tingles and does not currently go completely numb. On 4-6, bottom of left foot started to hurt.

Right now, it is 11 pm and I took my last Gabapentin at about 8:45. I am laying on the couch with my laptop. My feet are burning across the top of both feet and on the lateral sides of my ankles and calves and there is some burning on my medial side of my left calf. I also have some burning on my right thigh and on my right hamstring (they call it posterior thigh??) and I am getting intermittent glute and hamstring pain.
the gabapentin is wearing off.
My back pain is about a 4-7/10 and I have taken Darvocet and tylenol earlier in the day. And it is left and right-sided. Seems to be more right-sided today.
The back pain has gradually increased from when it started. Around mid-February (Valentine's Day) I was able to sit comfortably at a movie with medication. By 2-27, even taking Darvocet and Percocet (10 mg), I was unable to sit at my daughter's performance comfortably. I was squirmiing in my seat. My sitting tolerance improved and then declined.
I went to a conference on April 2 and was basically sitting on and off, but there were a lot of breaks. It went from 7:30 to about 4 pm. Afterwards went back to my room and was in a whole lot of pain, so took a Percocet.
I was taking Darvocet during the day (prescribed for four times a day prn).
I rested and then walked a short-distance to a restaurant and had about 7/10 back pain even after the percocet and darvocet had time to take effect and so I did a no-no and had a large beer. Got back to hotel room and still had severe pain and had taken all the meds allowed. I was also icing my back as much as possible.
Yesterday, I went and got x-rays and waited about 50 minutes. Went to neurosurgeon appt, about 40 minute wait and then in and out. At night, had severe pain. took Darvocet and Percocet together, sat on ice pad. Had back and leg pain and could not sleep because of the pain. Took sleeping pill (rare for me) and that did it.
I am sure some of my pain and numbness today is due to yesterday's sitting.
I have had one facet block and three ESIs since January. Before the last ESI, I almost fell down when I got up quickly from a nap (phone was ringing) and my left leg was asleep and right foot was numb too. Got two day "relief" with that ESI.
I have gone from taking no narcotics, only Tylenol, to taking narcotics 3-4 days a week to taking them everyday. The back pain has gradually increased as the leg pain has remained mostly the same.
The back pain ranges from spasms to burning (like tenditinitis) to a deep pain. I also had thrown into the mix some SI Joint pain and my SI joints move out of place pretty regularly. Was out of place today and put back by PT.
Pain doc told me he thought sciatica/numbness was from L5/S1. Not sure about back pain so disco on Thursday next week. I am nervous but ready. Seven months of this is too long.

This is pretty lengthy but you asked me what the pain felt like.
Be careful of what you ask for.

runner

[Justin]

runner,

Thanks for your detailed reply. Seven month is too long. I'm so sorry that you are going through all of this. With your description, it definitely sounds like L5/S1 is implicated in your pain. (Of course, this is my personal opinion.)

I do hope the discogram reveals, or it least confirms, the culprit of your pain. I wish you the very best and please keep us posted after Thursday of next week.

Keep your head up--we're here for you.

[runner]

Thank you,

Justin. It means a lot that you and others on here care.

[mmglobal]

Hey Runner, what is generating the forward or backward talk? Sorry things are so tough now... I hope you can get some relief.

Mark

PS... I've recently seen a repeat ADR case.... interesting similarities to your case. Feel like another art walk?