The lesser of the 2 evils?

[martyusa]

My Surgeon has put me on Lyrica for the nerve pain problems that I have been having from the supposed damaged nerve root at L5-S1. Sciatic pain is not as bad as the pain in the big toe as well and the numbness in the other toes. Feet are cold most of the time. The mass majority of these symptoms are brought on with increased activity. The doses of the Lyrica are 150mgs at night and I take 75 mgs around noonish.

It's been about 1 week and I must say the first couple of days were great. No more waking up in the middle of the night. However, lately I have noticed some serious fluid retention and my BP meds are not touching the hypertension problems. i.e. 50mgs of Toprol-XL, 150 mgs of Tekturna with a mild Diuretic. I have yet to take my afternoon dose and have replaced it with 40 mgs of Lasix. Which of about an hour later was followed by some extra potassium and a multivitamin.

Now the Percocet , which I came off of in place of the lyrica, worked OK and made the pain tolerable. Although it was still there it took the edge off of the sharpness. NSAIDS are out of the question, so my options are limited. Yes the pain can raise my BP as can the increase in fluids brought on by the Lyrica and I find myself in a catch 22 here.

I do not mind a mild diuretic with the other BP meds. I do not like taking a loop diuretic due to the fact that it pulls more that water out of the body. i.e. just about every nutrient the organs hold. But I do have the lasix for emergencies like this morning.

I will be speaking to both my PCP and my Surgeon. But my thought are this. The Lyrica must go as it seems not to be worth the side effect for my situation. If I must stay on the Percocet, current BP meds and Diazapam until something can be done, then so be it. When 12.5 mgs of Ambien doesn't keep me sleeping for at least 6 hours, we have a problem. I wake up about 3 hours into sleep and I needed to take 5 mgs of diazapam and 5 mgs of percocet to fall back to sleep, pre Lyrica. If my BP stays high, I will not get clearance for the procedure on the 25th. Septum, Tonsil and adenoids. Which should also help me sleep after it is done.

The assistant did give me some literature about a device they place into my body for some type of electric stimulation to help with the pain. But I feel my pain is not bad enough for something to that extreme. It's not like I can't walk or perform the average task while taking my normal pain meds for a limited period of time. And I don't want to get caught up as an insurance guinea pig test subject either.

As if "we all" don't have enough stress in my lives right now dealing with insurance companies, both medical and Disability as well as our employers. It's just seems to be a big mess as I toss my hands up in the air thinking "what else".

[guymontag]

Hi

Hi Marty. I've just read your history about your fusion. I just wanted to clarify something. with this CD HORIZON® LEGACY™ PEEK Rod System, is this a posterior operation? your discs ar l4-l5 and l5-s1 were not removed? if so, why did the surgeon opt to do a standard posterior lateral gutter fusion rather than an interbody fusion like a PLIF TLIF ALIF? Question now arises if the disc is leaking chemical proteins will it stop as the fusion progresses over time?

The reason why I ask is, my symptoms are so similar to yours. I haven't had a fusion but I have had a microdiscectomy(l5-s1) done on 1st july 2008. I was fine for 5 weeks, I had a very little stumble and felt a small surge of sciatica and now its been over3-4 months and I've been having to deal with a lot of nerve pain on both sides all down my leg + numbness in my feet which i never had pre-op. I did get an MRI done and everything checked out normal, doctor said don't worry.

I've researched this to death and I'm absolutely sure without being 100% postiive without a discograph that I have internal disc disruption/ annular tear such as Doug Gillard has described on his website ChiroGeek's Home Page, and I'm getting chemical irritation from a leaking disc.

Sorry, I'm not trying to hijack your thread but what you describe is uncannily what I've got. I've got a bunch of theories as well as a conservative remedy which I'm trying out and will save for a new thread....

[martyusa]

Believe me when I tell you I tried everything I could. I do not suggest using anything without consulting your doctor, but I even tried doses of Adequan in an attempt to assist in the healing of at least L4-L5. L5-S1 was completely blown through as the discogram showed. So I believe there will some chemical leakage and/or some problems with the chemical leaking out while the back is under a load. Which when anyone looks that up you will start to see the conspiracy behind our human medical system. I will be talking to him on the 22nd and speak to him about that. I'm not sure I'm ready to go through all of that again just yet.

And on a side note...Does anyone know if they do an MRI while putting the body under a load or weighted down? I think this would save all kinds of time if there were comparative MRI's with and without loads to see what the extent on the damage would be with the onset of non-consistent symptoms. Just a thought!!

[Maria]

Marty,
Have you tried Neurontin, Topamax or something like Elavil for the pain?

[martyusa]

Originally Posted by Maria

Marty,
Have you tried Neurontin, Topamax or something like Elavil for the pain?

Yes, I was on Neurontin, but the doses were so low it would have been no different that a Placebo effect. I have a neighbor who take 3400 mgs everyday and literally take 3 cups full of pills everyday. Granted his condition is the neck area and worse than mine. But the last thing I want is to feel stupid being doped up all the time. I'd almost rather deal with the pain that is somewhat controlled with short term meds and keep my whits about me. If I'm gonna have a constant 4-6 pain level, fine. Just tell me and I'll make an attempt to make that a new baseline for me.

Still waiting on a call back from the doc.

[mmglobal]

most of the time I was on Neurontin was at 900mg/day. I did not like the brain fog and would not let the doc ramp me up to 3600. Rarely, I would take a 4th 300mg neurontin at night to help sleep.

This level of medication did help substantially with my leg pain.

[guymontag]

I still don't understand why they didn't remove the discs, esp at l5-s1. ? especially if "l5-s1 is blown out"

[mmglobal]

As I understand it, the peek rod systems are designed to be flexible and are used in conjunction with some sort of interbody spacer.

Mark

[martyusa]

Originally Posted by mmglobal

most of the time I was on Neurontin was at 900mg/day. I did not like the brain fog and would not let the doc ramp me up to 3600. Rarely, I would take a 4th 300mg neurontin at night to help sleep.

This level of medication did help substantially with my leg pain.

That's the biggest problem I has with my oops...For months I was taking 3 100mg tabs at night before bed. And yes it did help me get through the night a bit. During my last re-fill, I was given a 3 month supply. What they failed to tell me and what I failed to look at was it went from 100 mg tabs to 300 mg tabs. So I was still taking the 3 tabs as I habitually had taken for months. I didn't notice much of a decrease in pain as I did feeling cloudy. Almost as if I had a sluggish, congested type head cold with almost 0 concentration. Almost like it was an extra effort I had to put forth.

I didn't notice the problem until I went to refill after 30 days.....Now everything goes into a daily pill tray. If Monday is empty, I know I already had taken it. Pain meds are on the 3's...i.e. 12,3,6,9 and so on. I just count whats left if I think I missed one. It's kinda scary when you can't remember if you took your meds 20 minutes ago!!!!

[martyusa]

Originally Posted by mmglobal

As I understand it, the peek rod systems are designed to be flexible and are used in conjunction with some sort of interbody spacer.

Mark

That's the way I understood it. Unless he felt the discs were not that bad off, but I still feel a constant pain on the right side in the back and upper glute. Maybe your onto that Chemical leakage you were talking about. Only toe and sciatic pain with increased activity or prolonged sitting really flares it up.

Time will tell.

[guymontag]

but the spacer doesn't necessitate removing the whole disk? or am I reading it all wrong

from martyusa cat scan report

L4-L5 There is a mild broad based disc bulge but no herniation or subarticular recess narrowing. The disc bulge causes mild urinary both neural foramina without impingements of the nerve roots. Unchanged from MRI

L5-S1 There is a broad-based disc bulge with a right subarticular disc protrusion touching but not compressing the right S1 nerve root and right subarticular recess. The disc bulge causes mild inferior both neural foramen without impingement of the L5 nerve root. Unchanged from MRI

which would indicate that there is still a disc there?

I wold have thought if the disc was so bad they would have done a PLIF or an ALIF and actually removed the entire disk(this is what happens in a PLIF or ALIF isn't it?), or may of suggested the route of fuse L5-s1 and ADR l4-l5.

I'm just so suprised that most docotrs don't recognise chemical radiculopathy from a damaged disc. My GP thought I was out of my mind whn I even suggested it. I think it is more common than they realise.

[dshobbies]

The brain fog and lack of concentration were difficult to live with while on Neurontin, 2700mg daily, but the pain would have been worse. I tried twice to get off until this time last year when pain was finally at livable levels. If not remembering where I left my head was the price I had to pay for pain free days, so be it. However, knowing where it is makes life a little easier!

[mmglobal]

Guy's point is well taken... reviewing radiologist report from Marty's other thread... sounds like no interbody spacer is discussed and disc bulges are still present, but the report seems to minimize the impact on the neural structures.

[Eddie G]

I prefer Neurontin to Lyrica. I take 1800-2400mg and it helps the leg pain. I never got foggy but I do get foggy from the Oxy so who knows.

You definitely need a strong back for the 'ol ground & pound. I can't imagine trying to wrestle with my back. Are you a heavyweight? Maybe when you get better you can fight Lesnar. I wouldn't blame you if you fight him dirty either. The only way to beat that guy is to punch him in the yambag!

[martyusa]

Originally Posted by Eddie G

I prefer Neurontin to Lyrica. I take 1800-2400mg and it helps the leg pain. I never got foggy but I do get foggy from the Oxy so who knows.

You definitely need a strong back for the 'ol ground & pound. I can't imagine trying to wrestle with my back. Are you a heavyweight? Maybe when you get better you can fight Lesnar. I wouldn't blame you if you fight him dirty either. The only way to beat that guy is to punch him in the yambag!

On stage I was teetering from Middle to light heavy (176-185). I would never roll at that weight due to the simple fact of how depleted the body is. I would now jump in about 200. However, in my youth I was full of P+V at 140.

BTW, they all fight dirty. But it's a clean kinda dirty. No groin shots and no eyes. PKA and KICK rule were different when I started, then it became real and that's when the real pain started. Luckily I had a great ground coach and live only 1 hour from the Dillman camp. Dillman was great for P.P. training which was great for us strikers learning ground later.

It was fun while it lasted. But at 42, one must face reality and realize that it's over. Knowing what I know now, I never would have gone F.C. It's not worth it when we get older. The ones that suffer are the kids and that's just not fair to them.