May I ask, did you have a two- level fusion, L4-5, L5-S-1, or did you have one level fused initially, then had a second surgery for the second level? Actually, this does make a difference.
Again, your saying that this surgery is a minimally- invasive procedure.
And this make a huge difference: are you considering open back neuro- surgery, or a minimally- invasive procedure?
If you're considering a minimally-invasive procedure on a level that has proven to relieve pain when treated with an injection, well, that's a fairly good indication.
As Annette said, as reply to your writing that you still have many questions- by all means, ASK every question. If you're not certain that you completely understand the answers, tell the MD that, too.
After you get your questions answered, and if it is a minimally- invasive procedure, then you'll probably be better able to make an informed decision.
Psymommy, what sort of "alternative treatments" would be indicated for neuro- genic pain caused by pressure on spinal nerves? Clearly, NOT chiropractic, which is not indicated in spinal nerve conditions.
Since chiros are only allowed to use X-rays as the sole diagnostic tool, they can cause significant harm to an unstable vertebral column.
Another concern with "alternative treatments" is that insurance companies not cover many of these pseudo- therapies.
Some do cover chiropractic, but chiro isn't a good option for neuro. problems.
Some also cover acupuncture, although the scientific evidence doesn't support acupuncture as an effective treatment for spinal nerve compression.
Biofeedback can be quite helpful in long- term pain management, but biofeedback is no longer considered an " alternative" medical treatment.
Once there is scientific evidence that an alternative treatment is effective, it is no longer called "alternative"; it is then called medical treatment.
Be careful. The non- scientifically supported "alternative" treatments are quite expensive and most do or stand up as effective when exposed to scientific study.
Best wishes, and I do hope that you'll come back and tell us what you're thinking,
A few times, at least, over these past five or six months, I've wondered how you are and hopes that you'd come back and update us on your progress.
With such a gradual titration down, are you finding that you require the ancillary comfort meds for withdrawal symptoms?
One would think, considering that you take a long- acting med, the MSC, and a short-acting Perc PRN, or as needed, that you'd begin by discontinuing the PRN Percocet.
If you require Percocet four times a day for breakthrough pain, this indicates, at least to me, that you, like many of us, require daily opiate therapy to function at any level resembling normal.
Back when you opened this discussion, them was a little back-and- forth chatter about benzodiazepine use in opiate withdrawal.
Has your MD addresses this at all?
Last, if you don't mind my asking: do you take any meds for the ADHD? If so, I hope that your prescribing MD is aware of these.
I think you know that I'm an RN, but I've been away from clinical practice for a while, due to my injuries. I'm familiar with the drug Cimetidine, but don't know it's indication for withdrawal symptoms.
Can you, or someone out there, please explain?
Meanwhile, I'll continue to look for med info that would explain its use in w/d.
I've not seen any new regulation except the change of hydrocodone from a Schedule III to a Schedule II.
The scuttle among health care providers and professionals is that insurers have set some- sort of ceiling at 180 mg/ day of Morphine or the bio-equivalent.
This is the "magic number", per my MD.
Since my daily dosage is less- than 180 mg of Morphine Sulfate Continuous Release (MSC), my Rx hasn't been lowered or changed in any way.
A friend of mine, who was taking extremely- high doses of a combination opiate therapy: MSContin, Methadone, and oxycodone.
It has taken many years of tolerance to get him high dose, multi- agent regimen, but it works.
His MD wants to get him down to 180 mg/ day, which seems insane. I don't know all of his doses, but I so know that his MSC alone was 900 mg/ day. He is so screwed.
My MD and neuro- surgeon both limit implanted intrathecal delivery (pain pump) to end stage cancer patients. They both have told me that, with intrathecal delivery, tolerance occurs much more quickly than by mouth or intra dermal delivery.
This is just two MDs opinion related to one patient (me), but before I had the SCS, when investigating the "pump", my MD thought that Fentanyl patch would offer the same pain management and wouldn't incur tolerance as quickly.
I did extremely well on the fentanyl patch, then opted for SCS, and my pain med requirement decreased over 50% over six months.
Pain- wise, I could have done fine with the lower doses immediately, but it took six months to titrate down and prevent those disgusting withdrawal symptoms.
The Whipple Procedure is a huge surgery, and it's only been three and a half weeks!
You will need time to heal.
Since you've had infection, the recovery time will be even longer.
Even with the simplest of surgeries,not he first six weeks is considered the post- op period. With an extensive surgery like the Whipple procedure, with a post- op infection, it would be quite uncommon if you weren't still feeling pain, discomfort, interrupted sleep, Etc.
I'm surprised that your surgeon didn't emphasize these things.
Yes, the pain will get better as you heal more.
I hope that the surgery was successful in whatever was the objective.
It is your part to tell your MD about your pain, your current meds, what helps and what makes the pain worse.
Of course, be brutally honest, because the more information that you can share with the MD, the better he or she can do his or her part, which is evaluating your answers, probably ask you more questions, and decide which opiate may be best suited for you.
Brutal honesty included your concerns about the cost of brand- name medicines. Many of the most- widely used opiate meds are available in generic form.
OxyContin was, on the recent past, available as a generic, but is not now. There is a reason for this, but it's a long and somewhat boring narrative, so I'll leave it at this for now.
There is also a rather recent blood test that can assist pain management MDs to identify which opiate agent has the best chance if being effective for your genetic make up.
I had plantar fasciitis once, years back, and my MD attributed it to running without warming up.
I took anti- inflammatories, took some time off from running, and it got better.
I recall being somewhat surprised that inflamed fascia could be so painful. I don't remember what it felt like, but I do remember that it was very, very painful.
JMHO, but you have a diagnosis and a treatment plan.
You've had recent blood studies, and, as you said, "all is well".
I don't see any reason to consult with a neurologist at this point, nor should you suspect spine problems, or fibromyalgia.
Please wait until you try the orthotics, rest your feet while the inflammation subsides, and take anti- inflammatory meds to reduce both pain and inflammation.
If, after the time frame suggested by your podiatrist, your symptoms don't subside, become worse, or other symptoms emerge, then you're primary care MD and/ or podiatrist recommend that you should have further medical care.
Since you have a diagnosis and a treatment plan, should you go to a neurologist with a diagnosis of plantar fasciitis, what would you wish the neurologist do for you?
Please be patient with the current treatment plan, and give yourself a little more time to heal.View Thread