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 smile

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  • Posted

    Unless the statute of limitations has already passed or if your case has already been settled, talk to the lawyer handling your accident claim. Without knowing more, I think that's what the dr meant by "medico-legal issues."  
    • Posted

      My compensation claim is still on going and there has been no contact with the Drs from my solicitor and there won't be any until my treatment has finished, I am the one that told my consultant about my claim it just feels like he is accusing me of something when I have been nothing but honest with him and all I want is to be without pain.
  • Posted

    Guess you are Ginge944 in the States and not the UK.  There is I think a list of surgeons in the States on Spine Health website, and in England on ADRSupportUK.  

    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

    • Posted

      I am in uk and the consultant I have is a spinal specialist and meant to be among the best in the country sad I am currently on a repeat prescription for the following

      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.

    • Posted

      Amitriptyline is a superb nerve pain killer and is given to people who can't tolerate Gabapentine or pregabalin. This is the exact reason why I'm on 100mg per day.

      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.

    • Posted

      Who is your consultant in uk? Hope you don't mind me asking
    • Posted

      Not at all my consultants name is Mr Summers
    • Posted

      Hi again, its just that ADRSupportUK keep a list of surgeons that patients recommend. Can I mention his name?  Sorry forgot to ask what part of England are you.....  Also you don't mention the other operations, I guess this might be for discs?  You can message me if you like.

      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..........

       

  • Posted

    I read it this way.

    * 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.

     

    • Posted

      Hi Suzy,

      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. sad 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.

    • Posted

      Also is there no chance they can operate again ? I have seen that surgeons can preform it a cpl of times or maybe a different way? Is there no improvement on your condition since the operation at all?
    • Posted

      Hey, which part of uk are you in?? I couldn't take tramadol as it made me so sick all the time, my pain Dr put me on a fairly new drug in UK called targinact it's a morphine based drug but has the antidote in to stop you being drowsy and sick, worked great for me, I also take Amertriptiline 150mg at night, 10mg diazapam 3 X a day along with many other drugs, I stopped the pregablin as I had a side effect of massive weight gain I put on 15kg being on it and the pain team took me off and I lost it in 3 weeks, they said lots of people suffer from it as it retains fluid, not sure if other had same e perience?? Seems like your Getting lots of good advice in this chat and hopefully it will help you :-)
    • Posted

      I am from Shropshire, I am currently under the Trauma & Orthopaedic department at the Princess Royal Hospital and I am lead to believe the consultant spinal surgeon I have is one of the best in the country I'm just finding it hard to understand how and why my review report is written the way it is.

      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 sad and the pain clinic as referred me back to the consultant surgeon.

    • Posted

      No, my surgery was a longtime ago, and the fusion was with bone taken from my hip. Over the years the bone has grown, made new bone and gone up two levels at one side and one level at the other.

      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.

    • Posted

      That sounds very painful an uncomfortable to be dealing with I hope it's not a common outcome of the fusion/decompression proceduresad I really do hope u can get a fix for your problemsmile.

      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)

    • Posted

      Right, that puts things in a different light.

      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.

    • Posted

      The box has a tick in the enable private message and I did google the yellow flags and there were a few different articles I have read. I am definitely open to seeing more smile and I started with light duties for about 3 months and then progressively increased my work output I didn't think my injurys were that serious at the time due to me being discharged from hospital care which was before my mri scan but after my first X-Ray's, hope I'm not confusing you smile
    • Posted

      Crikey that's what is wrong with me with lyrica i'm fighting my weight all the time. I take 38% tramadol an the rest paracetamol and its surprising I could tolerate 100% tramadol. Different folks different strokes - wish I could get my meds to work.
    • Posted

      I put loads of weight on taking lyrics.

      Changed to gabapentin, works better on nerve pain for me, and doesn't seem to affect my weight.

    • Posted

      Suzy would you mind telling what else you take with the gabapentin? They say lyrica gabapentin and pregabalin all put on weight - its like playing the game with me.... I have probably had the lot except fusion and now in Spain I am having to play the game here. All takes time between appointments and treatment fed up I will be popping my clogs by the time they have finished with me.also had a wedge fitted between discs and decompression. Waiting now to have xray led spine injection. I would buy a drug to try if thec3 above weren't so expensive
    • Posted

      I have never heard of anyone having a spinal injection that works

    • Posted

      I had a spinal back in May last year. Made me worse for about 6 weeks afterwards.
    • Posted

      Don't be put off trying injections, I've had lots of different ones over the years.

      I do know people who have them every few months, mainly steroid ones, because they have worked for them.

      They do need repeating though.

    • Posted

      Hi, have just joined as so fed up not being able to get spine surgery. I will post the whole story on the forum, it is very long! But I was very interested in the link you found and sent to ginge944, I'm not sure how to get links etc as I said I've just joined.

      linda

    • Posted

      I have forwarded the link to you Linda hope it is as much help to you as it is to me in understanding what the yellow flags mean and looking forward to reading your story smile
    • Posted

      Replied to this earlier, it seems to have disappeared, I take Naproxin 250mg four times a day, plus 200mg Gabapentin four times a day.

      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. 

    • Posted

      Sick of having ongoing injections though most of mine never worked.once I was so so in pain I went to Warrington and Mr shackleford did it. Looking back it was funny I paid 1,000 pounds. I had the injection and he had 3 young girls in theater,laughing and joking he started to slag off a town I know I was a bit cross anyway in the bed afterwards I tried to get off the bed , I got off but actually fell off. We did laugh the injection was really strong but it only lasted a couple of months so I am no expecting much when I have the next on.

      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...

    • Posted

      Sorry to be a real nuisance but where do I find the link!!
    • Posted

      I haven't fallen off any beds yet!

      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.

    • Posted

      look at the top RHS, where your username is, and se if you have any messages.

      If not, just google   yellow flags medical terminology .

    • Posted

      I had amytriptoline in the uk but it upset my stomach I could not take 100% tramadol either. So my Dr put me on pazital which is 38% tramadol the rest paracetamol. Which help underlined but they are big tablets. So I went generic it seems there are about 4 generic ones but can't remember where I got the round small round ones!!! We go benidorm Alicante and Valencia so maybe one day I will pick up on the farmacia. Did I \read that paracetamol doesn't help pain? Think I threw the article away but at this time of year uni students research papers are out I think so maybe it was the mail.

      Arh so that's where you put the links ha ha

    • Posted

      Got it thanks. I don't like being the newby and have to ask questions of everyone.

      linda

    • Posted

      Amitriptyline can be used as an antidepressant but also as a nerve painkiller and has worked for me in conjunction with Carbamazepine.

      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.

    • Posted

      Err, do you not think the second para of your post is a bit rude. Amytriptoline was not good for me either.  but I think your second paragraph was a bit strong.  gabapentine is good for nerve pain as is Lyrica and pregabalin 9that I know of) Different folks, different strokes.
    • Posted

      I don't think so. The statement was made that Amitriptyline is an antidepressant and to quote 'not very good for nerve pain'. It's a sweeping statement that some would read and say 'well I'll not try that as its no good for my nerve pain'. I have experienced the exact opposite. If it read 'Amitriptyline didn't work for me but had for some' I wouldn't have commented but it doesn't. The comment is in no way rude. It states fact.
    • Posted

      I can't take any of those drugs so far that help nerve pain or change my brain signals. Topomax did nothing. Zoloft had me seeing giant gnomes standing next to my bed the first night, and some creature that was a very feminine male on the top and a horse on the bottom.Then I didn't want to take that anymore. Lyrica made me unable to move, walk, watch TV or do anything but sit on the couch holding tight with the world spinning round me. Gabertine, (Neurontin), made the numb part of my toes and then entire foot twich like it was posessed, (freaked out the kids when we were watching TV at night), and then half of my face went numb. I didn't want to try anymore of this brain altering stuff here in the

      US afer that! I'm so glad it's helping some of you though smile

    • Posted

      Ps I wouldn't say gabapentine or pregabalin and not good for nerve pain. They weren't for me! That's the difference in statements.
    • Posted

      Kathy, have you tried Carbamazepine? Don't know if it's called something different in the US? It's an epileptic drug but pain clinics can prescribe it for nerve pain. The meds you tried above did the same to me but have helped my mum with her nerve pain.
    • Posted

      I was honestly afraid to try anything after the centurion hallucination! I'll look it up though. I've been on a bunch of drugs over the years for my migraines. It seems that there are some that are useful for a variety of things. I'll check with my neurologist and get my records to see if we've tried it yet.I don't really know how much of my back pain is from nerve damage. I'm seeing a new pain Dr for a second visit in a couple weeks and have had l my surgical/spinal injection records faxed to him, so I'm hoping he can help figure me out. My surgeries have caused many muscles to contract that won't allow my hips to seat properly and stay that way, so my pelvis is always tilted both forward and to one side, causing other problems. I feel like a Rubix Cube. I'm a mess! Thank you!
    • Posted

      Well no, lyrcia is not 100% good for my pain either but I take Tramadol and Paracetamol too with it.   We do Valencia/Alicante on Wednesdays and I am not joking when I say by the time I get anywhere (20 mins) my pain is high and then I think I have to walk back to the car. My partner keeps talking to me to take my mind off the pain whilst I am walking. I don't know why I do it really but enjoy seeing my friends on my own. A few months ago - seems like weeks - I was so much in pain I went into the park to sit down, whether I didn't pick my handbag up there or whether I left it in a taxi but that is what happens to me - the pain gets so bad - and there was 60€ in there that I was secretly saving for my daughter a mattress!!!  But then I have tried amytriptoline and lots more that I can't remember, osteopathy, (sorry my memory goes)  the treatment where they stick pins in you (don't laugh it drives me mad) 4 X Ray lead spine injections, one costing me £1,000. Thats what pain does, you grab every opportunity and object you can think of to help cure the pain and so far found nothing.
    • Posted

      Hi Kathy, Gabertine - not heard of any of those side affects. Perhaps these are American drugs. Sometimes they make generic ones with different names.

      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.

    • Posted

      It's the medication. When I'm having a bad day and take a bit more medication than usual it affects my "word retrieval" and my short and long-term memory as well. I think the brain is so over-loaded just trying to manage the pain that it affects these things as well. Don't beat yourself up. We're all doing the best we can to swim through an ocean of garbage thrown at us, and we're not fish to begin with. Hang in there.

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