[treefrog]

Well, I followed others over here from the other place, although I had only been there for about a month. I believe you can never belong to too many forums. I hope that I can learn from those here, and contribute where I can. I was most impressed by the articles and abstracts section, as I am a scientist. I have already found several good articles.

An introduction.
My name is Cathy, and I’m 46 years old. I have hereditary lumbar DDD. I say that because both my mother and sister also have lower back problems. I always considered myself the lucky one, since I had never had an episode of acute back pain that kept me off my feet, whereas they both have. My pain has always been intermittent, coming and going since about 1993 or so (I can’t remember exactly the date when I first had pain while shoveling snow), but I have always been able to get around and take care of myself during the pain. But about two years ago the pain started again, and it hasn’t let up.

MRI results (Dec 2007):
-Transitional anatomy – S1 is partially lumbarized (meaning it isn’t fully fused).
- Minimal levoconvex curvature, apex to the left at the L5 level. Both alignment and height of the lumbar vertebrae is well maintained.
- L1-2, L2-3, L3-4 Normal disc contour, without canal, lateral recess, nor foraminal stenosis.
- L4-5 Mild-moderate disc degeneration with desiccation and slight height loss. Mixed fatty and edematous degenerative endplate change is present, most advanced to the right of midline. There is mild endplate osteophytic ridging, accompanying dorsal disc bulging, eccentric to the right. This leads to very minimal flattening of the right ventral thecal sac. No canal or lateral recess stenosis. There is mild right foraminal narrowing due to lateral component of disc bulge, as well as very mild lateral endplate osteophytic ridging.
- L5-S1 Mild disc degeneration with dessication. Mild-moderate degenerative facet changes are present bilaterally. Minimal dorsal disc bulge, without mass effect upon the thecal sac, No canal or lateral recess stenosis. Mild left foraminal narrowing due to facet hypertrophy and endplate ridging.

Discogram results (Dec 2008):
- L2-3 disc injected with 1 cc shows an opening pressure of 26 psi. Normal anatomy. No pain. Max psi is 88.
- L3-4 disc injected with 1 cc shows an opening pressure of 23 psi. Normal anatomy. Some end-of-injection right anterior thigh pain. Low intensity. Repeat injection with 1 cc reproduces no pain. Max psi is 120.
- L4-5 disc injected with 2 cc shows an opening pressure of less than 10. Diffuse degenerative anatomy. Early injection concordant right-sided hip and leg pain. 7/10 intensity that increases with increased pressure. Some pain with needle movement. Peak psi 60.
- L5-S1 disc injected with 3 cc shows an opening pressure of 12. Diffuse degenerative anatomy. Early to mid-injection concordant back and hip pain. 8 to 9/10 intensity that increases with increased pressure. Max psi 54.

Pain medications:
Darvocet – didn’t do anything for the pain.
Ultram-ER – made me sick, dizzy and gave me headaches, didn’t help the pain.
Vicodin – didn’t help the pain, and at higher doses made me “out of it” and affected my eyesight.
Fentanyl – made me extremely sick.
Percocet – helped the pain a little bit, but at higher doses made me dizzy and nauseated.
Opana-ER – helps with the pain, no side effects. Currently taking 20mg twice a day.

Other meds:
Relafen – might have helped some, but it was hard to tell.
Mobic – might help, again hard to tell. Currently taking 7.5 mg once a day.
Neurontin – helps some with the nerve pain, but doesn’t get rid of it altogether. Currently taking 300 mg; two pills at night, 1 pill in the morning and afternoon (1200 mg total).

Talked with an orthopedic surgeon after having the discogram. He recommends either a 2 level fusion (minimally invasive TLIF), or a Prodisc-L at L4/5 with fusion at L5/S1 (ALIF).

Hopefully I will be having a second opinion with a neurosurgeon. I’ve been faxing them all kinds of information, which is fine, I understand that he wants to review all my test results before forming an opinion. The only thing that bugged me is that he wanted the surgeons notes from the consultation, and I want an independent opinion. But, we’ll see what happens.

I have a fantastic PM doctor. She listens, doesn’t give me a hard time about meds, probably because I’ve always been honest with her.