When does the 48 hour clock start?

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Hello. I had surgery for CES in July of this year. My neurosurgeon told me that if surgery is performed within 48 hours, things will be generally better.

now I’ve also read tidbits here saying the same thing. My question is, when does this clock start?

now I know the easy answer is to say at the first sign of a problem. But honestly, that’s a cop out. I mean, I once felt a twinge a few years back. 48 hours from then?

48 hours from when your legs go numb? Bowels and bladder? 

At at what point is it safe to say, the clock has started?

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  • Posted

    Hello there;

    There is plenty of research about this on the www.  The consensus medical view seems to be that surgery within 48 hours of the onset of bladder or bowel disfunction is a good indicator of a good recovery.  Surgery within 6 hours is of course much better than 47 hours.  Beyond 48 hours, and the prognosis is quite poor.

    Best of luck with your recovery.


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  • Posted

    I think from when pain becomes severe and bowel bladder problems start


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  • Posted

    There is no easy answer - decompression surgery ought to take place within 24 - 48 hours of diagnosis, usually by MRI scan. That begs the question of whether there was a failure to diagnose sooner - your GP or Clinicians should have referred you for an emergency MRI if you were exhibiting 'red flag' symptoms of CES: Symptoms may include Neurological symptoms in the lower body. Weakness, tingling, or numbness in the saddle area; legs, feet. Lower body weakness or numbness; A particular red flag is altered sensation in the “saddle region,”  With cauda equina syndrome, all or parts of this region may have neurological symptoms of numbness, tingling, and/or weakness; also altered bladder or bowel function.

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    • Posted

      I was diagnosed at 10am on a Sunday morning by gap and sent to a&Zealand. The doc at a&E said I didn’t have Cauda Equina and refused to get second opinion even though I begged. I gave 4 hours trying to convince him I was in deep s**t and needed help. He sent me home with morphine. I had operations 8 days later. 


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    • Posted

      Briefly, what symptoms did you have by the time you first attended A&E (saddle numbness? bladder/bowel dysfunction?) and did they do a Per Rectum exam (sorry - but it is an important test).

      How many days later did you have an MRI?

      I am wondering whether you may have a medical negligence case, assuming this was within the last 3-years (there are other factors).

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