Spondylolistheses grade 2 with bilateral exit foraminal stenosis L5/S1
Posted , 9 users are following.
I am new to the forums and I'm very confused after recent events in my life.
I am a 40yr old gent and before my car accident I lived a perfect healthy an very active work and social life.
I was involved in a very nasty accident (passenger) of a car that rolled over multiple times at over 115mph was told very lucky to be alive by paramedics.
Since my accident I have been diagnosed as having
Spondylolistheses grade 2 with bilateral exit foraminal stenosis L5/S1
I have been struggling with very aggressive an excruciating pain in my lower back and left leg, continued pins/needles all down my leg and numbness. I have had an epidural in my spine for pain relief which didn't work I am taking several different types of medication and I can still only walk a short few steps on crutches before my pain is too much. My confusion is I recently had a consultation at prh orthopaedic department during which we spoke about a spinal fusion and nerve decompression operation which I was explained was not a cure but would maybe help me.
Why I was there I requested if I could maybe use a wheelchair for getting out house more (I can't leave house at the moment due to my pain) and was told to see my gp about which I presumed tobe normal procedure.
Well I have received today a copy of the ditated notes and there is a paragraph init that reads as follows,
He (me) does not really come across as a candidate for a spinal fusion and decompression. The pain is related to accident and there are various medico-legal issues. At the moment he is requesting a wheelchair. There are a lot of yellow flags around at the moment.
I'm contacting the pain clinic and see if they can see him sooner. After treatment we may consider referral to Oswestry for spinal fusion.
I have already been seen by pain clinic and received the treatment and it was a fail I am now awaiting a follow up appointment with my consultant which I am going to confront him about the report I got. Hope I not confused anyone I'm just after help with my situation.
Thanks
0 likes, 62 replies
Dog_Lover ginge944
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ginge944 Dog_Lover
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Enna1 ginge944
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I thought no doctor now prescribes Amytriptoline - I am not sure about other tablets you are on but I was in severe pain and still am if I walk too far like for 30 minutes, and I take Lyrica but Pregabalin and Gabapentin are similar.
Don't feel too upset about what he says, I too had years wasted in England where my doctor thought i was putting it on, and until i came to spain things didn't alter. I don't know what to say about these doctors that speak like this, they are so aragant (god my spellings gone to pot since i retired) there is an there is a very rude saying in England to describe them but can't put it on here. And I wouldn't worry about it, try being told that England doesn't put translators for Spanish people who can't speak English. That just about did me too.
As well as Lyrica I also take Pazital which is 38% TRamadol and the rest is made up of Paracetamol, its quite cheap 3€ in spain and you can buy it over the counter, but not so in England, dunno in the States.
I think we all know how you feel too I think most of us have had issues with drs at some time or other. The pain clinic in England the dr there told me there was nothing he could do which was a downright lie and handed my partner a leaflet on how to deal with the situation. Ba****rd I will remember him for the rest of my life and that was it, I couldn't go back to the Walton Clinic and I hear such good treatment for other people there. So its different folks different strokes. Did you go into the drs with a smile on your face. Thats what I do, but I have now changed. I don't. They think you are putting it on. I had the local pain clinic say "and when I called her name she got up off her chair very quickly! and I too have a copy of that.
So take it from me, we do get treated badly sometimes, start again, find another surgeon/consultant and start again. Be careful though, I went to a neurosurgeon and thought oh this bloke should be good and when I really got into this chaps credability, he was only clever at mending nerves in peoples heads, he was absolutely useless at backs and knackered my back up so i can't have fusion. Just be careful. Maybe come on this site UK if you live in the UK and see what people say about different consultants and likewise Spine Health for a consultant in the States.
Anne
ginge944 Enna1
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Amitriptyline 50mg daily
Codeine 120mg daily
Tramadol 400 mg daily
Naprosyn 1000mg daily
Mirtazipine 30mg daily
Omeprazole 20mg daily
I see my gp 3-4 times a month about the issues I have and is fully documented.
scott17436 Enna1
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Ginge944 try to see if you can trial Carbamazepine. Is officially a epilepsy drug but work to suppress nerve pain. It works well in conjunction with Amitriptyline. It's only your pain clinic that can prescribe it is way. No harm in asking. I've also found Diclofenac to be excellent in combination with these as well. A very under rated med.
If you get the right combination of meds (this can take quite a while) it can make a massive difference to your quality of life. I have also found coming off the heavy pain meds (MST, Dihydracodiene, Tramadol etc) it actually can help your pain. Sounds strange but it does.
Just be careful coming off anything and do it very slowly to stop any withdrawal.
Keep pushing and get to see the surgeon you want too. I've found (only in my experience) that orthopaedic spinal surgeons are better than Neurological surgeons. This is a very subjective view. I'm only taking from my experience. First op with Ortho worked, second op with Neuro failed and third op (just over two weeks ago) with same Ortho surgeon has been successful. Still early days but I am very confident.
Again, good luck.
Enna1 ginge944
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ginge944 Enna1
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Enna1 ginge944
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How are you now, up and at em then!!!Another saying from ADRSupportUK is "Slowly wins the race"
I had a surgeon who we highly recommended, I had no insurance and in desperation went to the surgeon nearly 6 years ago and paid privately. It took the money that I had made on my house after selling it to go to spain - unfortunately or fortunately. It has taken me 6 years to say this but I think his decompression has worked. I worked so hard in the garden that I was beyond myself, not with pain but tiredness. I just went to bed. I take my meds regularly because I was so much in pain afterwards and I am hoping that its not decompression that is Bursitis. My partner has just said that the dr I saw 2 weeks ago said the pain that I am having isn't the pain of discs being prolapsed/decompressed by the way I am having pain. I am praying that its bursitis and not my discs. A surgeon in valencia told me it was too dangerous to rectify my discs and I am so flipping glad he referred me to the pain clinic and to what they said. This morning I didn't take my meds till 11 and thats only because someone looked over me and said take them with a frown.
Oh boy will I jump for joy.... I do hope you get this matter resolved, I was told that I was a fraud too but not in the way you were told (I have it in writing) The letter said something like "Mrs Barnett despite complaining about pain in her back jumped up from her seat...... Whether he had chatted to my dr who thought I too was a fraud I don't know. I was just glad that I didn't need that pain clinic in the UK and hopefully the Gandia one will look after me, so far they have been absolutely fantastic. Trouble is..... the dr who did the bursitis injections (Lyrica makes me have bad memory/or is it my age lol / he didn't put all the consultations down on my notes but he is still in the hospital. But so so glad about my back, I have walked about 2 miles along the beach promenade today WITHOUT any pain.
It may have been my flowers in the garden, I will have to smell them more regularly lol
I have to say just one thing, different folks and different strokes. I said Amytriptoline didn't suit me and there was a question mark about it in the newspapers but then as I said different folks different strokes, I take Pazital its 38% Tramadol (I couldnt take 100%) and the rest is paracetamol and they say paracetamol doesn't work on nerve pain, but as the dr said its a low dose, and I know it is, I think my medical dr in the village thought i might do myself in !!!
I was going to mention something else but can't think of it now, Lyrica does that to me. I have pregabalin because the Benidorm farmacia didn't have lyrica so I am going to try that out and I think someone recommended Gabapentin. I'm working at it..........
Laura3333 ginge944
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* At the moment I do not think a decompression and spinal fusion is the best thing for this patient.
There are medical/ legal issues for him to deal with as this is due to an accident.
He is requesting a wheelchair ( I,e. Could you contact occupational therapy to sort out an assessment)
Just now, I am not sure what to do ( yellow flags )
I think the bast thing to do is to try and fast track him to the pain clinic.
if they can get on top of his pain, then would maybe be the time to refer to Oswestry for possible spinal fusion.*
This is just the way that I read it.
Medical speak in notes is usually very short and to the point, and to a patient can look very differently to how it actually reads to another doctor.
A few years ago, I paid to get all my medical notes, and there are a lot, printed out.
Purely for the reason that I had tried so many drugs that made me feel awful over the years, I wanted to make out some kind of pain med record.
The notes from various specialists to each other were fascinating, and had been written in the days before a patient had any right to see their own notes, so were quite blunt at times.
What I am saying, is the messages between doctors aren't always how you read them.
Nowhere does it say that he thinks you are a fraud, or that he doesn't believe you.
He is just proceeding with caution. After all it's a big surgery, they don't undertake it lightly.
Hope this different view helps.
PS I am one of the unlucky ones who did have a nerve decompression and fusion which failed, and I would go back and have it undone if I could.
ginge944 Laura3333
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Thank you for your reply I must admit that when you break it down like that then maybe I am reading it wrong hense taking it the wrong way. There actually is a full stop at the end of each segment which could mean that it is meant the way you have said but I am unsure and uncertain how to read his report it just comes across as if he is doubtful of my issues that I am suffering with and how I wrote the paragraph is exactly how it is written in the report, you have made a very valid point though and I'm reading it again now but still seems as though he is being accusing. it's just the way it is written that's bugging me a lot.
He (me) does not really come across as a candidate for a spinal fusion and decompression. The pain is related to accident and there are various medico-legal issues. At the moment he is requesting a wheelchair. There are a lot of yellow flags around at the moment.
It's the yellow flags bit that is bugging me the most.
ginge944 Laura3333
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buggsy1000 ginge944
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ginge944 buggsy1000
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Can I add that I am quite shocked in the amount of amitriptyline some of the ppl are taking I have been told I can not increase my dose due to my weight/other meds I take.
Also I have received the epidural into my spine for pain relief and it had absolutely no effect at all on my pain level and the pain clinic as referred me back to the consultant surgeon.
Laura3333 ginge944
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It was originally l5/s1.
I.now have arthritis in my spine which affects other levels, also my disc spaces are virtually non existent.
My main problem is leg and back pain, constant and unrelenting.
The best drug combination for me is gabapentin for the nerve pain and naproxen for the inflamed spinal nerves. It dulls the pain.
Epidurals and spinal steroid injections don't do anything for me.
How long ago was your accident ?
If not too long there may be still a chance it could settle down a bit.
I can see the way you are reading the report, but it seems unlikely in the case that he has copied you in on it.
ginge944 Laura3333
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I had my accident in 2014 and I had some time of work and then resumed light duties but in 2015 I was unable to carry out my normal duties and suffered quite a nasty fall due to my back and left leg pain which suddenly come on. I am a mechanical engineer and it was during removal of a gearbox that this happened.
He was not aware that I had access to my medical file the report was done before my access was granted. (Hope I explain correctly)
Laura3333 ginge944
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Try googling. ( Medical terminology. Yellow flags. )
It's explained as being afraid to do more because the patient thinks it will make their condition worse.
If you enable private messaging in your profile on this site, I will send you an interesting link that I found.
Removing a gearbox, light duties, noooo,you shouldn't have been doing that, even using machinery. :-/
You can't send links on the forums I don't think.
ginge944 Laura3333
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Laura3333 ginge944
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Have pm'd you.
Enna1 buggsy1000
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Laura3333 Enna1
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Changed to gabapentin, works better on nerve pain for me, and doesn't seem to affect my weight.
Enna1 Laura3333
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Enna1 Laura3333
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scott17436 Enna1
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Laura3333 Enna1
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I do know people who have them every few months, mainly steroid ones, because they have worked for them.
They do need repeating though.
linda1718 Laura3333
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linda
ginge944 linda1718
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Laura3333 Enna1
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If having a bad day I up my Gabapentin, and add 10mg diazepam, which dulls the burning pins and needles a bit.
I did get up to 800 mg Gabapentin four times daily, then my body got used to it and I had to come off it for a while so I could start on a lower dose again.
I pretty much self manage my pain meds, my body is so used to them now, but taking from scratch you need a doctor's advice on the dosage.
Enna1 Laura3333
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Gabspentin.....do you have problems with memory? They say gabapentin,lyrica and pregabalin are the same...they were first used on people with nerve pain (cant think what it was) but tried pregabalin because the chemist had no lyrics but I felta lot better. Just wondered...
linda1718 ginge944
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Laura3333 Enna1
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No I don't have any problems with memory, I don't think.
Pregabalin and Lyrica are the same drug, used for epilepsy originally.
Gabapentin is a neurological drug for nerve damage, works differently.
Amytriptiline is an anti depressant, supposed to work to damp down anxiety, and works in the same way on pain, but not very good for nerve pain.
Laura3333 linda1718
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If not, just google yellow flags medical terminology .
Enna1 Laura3333
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Arh so that's where you put the links ha ha
linda1718 Laura3333
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linda
scott17436 Laura3333
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Please don't make sweeping statements that a drug isn't good for something simply because you have read that somewhere or it hasn't worked for you.
Different meds work for some and not for others and it's about finding the balance and combination that work for you. Pregabalin and gabapentine don't work for me as they make me feel very sickly. Amitriptyline doesn't have this affect on me.
The combination I am on just now took over 18 months to get right. It's still not 100% effective but it's the best I've been on so far.
Enna1 scott17436
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scott17436 Enna1
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kathy07828 Enna1
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US afer that! I'm so glad it's helping some of you though
scott17436 Enna1
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scott17436 kathy07828
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kathy07828 scott17436
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Enna1 scott17436
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Enna1 kathy07828
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Lyrica is OK for me but doesn't do much for my pain, but I will tell you about that tomorrow.
Peter has to remind me of silly words with Lyrica - this morning I couldn't think what the word "crane" was as we watched the crane putting - oh God here I go - oh it doesn't matter. Thats how it goes. Just simple words that I know sometimes I come up with the words a few minutes later or maybe not.
kathy07828 Enna1
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