[Maria]

Mark,
As you know I've been on long term low dose use of Methadone for LBP and Neurontin and the wonderful ESIs that WC hardly wants to authorize...

Ok so if I were covering this pain and then flaring it up and my MRI results showed significant deterioration over a short period of time or even a longer period of time and then the pain/flare ups were becoming more nasty even tho I utilized meds to calm down the worse of it.. I believe I would have had surgery by now.

Fact is most of the time I've felt fairly well controlled given that I don't do much must factor in as well but I needed to feel really really bad like I did in the old days before entering into another surgery or see that my MRI/CT/discogram whatever testing is correlating with my symptoms for me to move on to surgery.

If the meds just cover acute flare ups but one is worsening both symptomatically and via diagnostic testing that seems to be reason to move on to surgery if it is warrented.

Now my neck is different story. I took 3 Fioricets and 1 skelaxin last night and still couldn't sleep for cervical pain. Today I feel like crap. But my MRI just shows an insignificant bulge at C5/6 according to the OSS.

This sucker hurts bad when it flares up...

Is this crushing arm and chest pain a new symptom?? It seems to be something you'd better mention to both the spine doc's you're consulting w/as well as you're PCP and maybe something you'd be best having checked out at Urgent Care or the ER (I know you were just there..). Have you had a recent EKG or any cardiac testing (I know you said these symptoms can be part of the cervical picture)... just don't want you to miss anything because you are *sure* it's all cervical/thoracic spine dx going on.. I don't mean to overstep any boundries as I recognize that you have Diane in your corner and she would push you to anything she thought necessary re the symptoms.