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| I'm facing more surgery; Advice please anyone? | |
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| Tweet Topic Started: 11 May 2010, 02:59 PM (2,288 Views) | |
| dalhousie | 19 May 2010, 09:53 AM Post #16 |
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I asked about this subject when I had my ADR done as I had flared a knee problem up & usually take Meloxicam which is a Cox 2 anti-inflammatory. I was told Iburprofen is worse for inhibiting bone growth than Meloxicam. I have a feeling Diclofenac may be in a similar group to Ibuprofen but not sure on that one. Having said that, they used Ibuprofen routinely post op when I was in hospital. |
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2005 Anterior fusion L1/2 with BMP & floating rib removed. 2009 ADR (activ L) L4/5. 2010 Chronic pain from Facet Joints T10-L2 with lots of muscle pain 2013 Attended Walton PM Programme: not much help. 2014 Chronic Pain - Facet Joints L4-S1 2017 Nevro SCS for thoraco-lumbar & lower lumbar facet joint pain | |
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| ajj1001 | 19 May 2010, 03:19 PM Post #17 |
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I was on diclofenac for one week post surgery to reduce inflammation and then told to not take it anymore which I was more than happy with as it irritates my stomach. I had a spinal nurse that I could contact with any questions like this, is there someone at Guys who deals with things like this? |
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Std Meds Gabapentin, MR Tramadol, Paracetemol, Laxatives 2011 Sept PLIF L4 - S1 2010 May Discogram L2/L3 & L3/L4 both looking ok. 2009 May PLG Fusion L5/S1 Charite in situ April Dismissed 2008 Caudal Epidural failed to work 2007 Deterioration L5/S1 Facet arthritis, Loss of disc height. 2004 Returned to Work 2002 Aug - physio March 2 level ADR Charite L4/5, L5/S1 2000 Broadbased disc prolapses L4/5, L5/S1 | |
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| Mrs R | 19 May 2010, 04:46 PM Post #18 |
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Not that I know of Alison, it seems to me you practically need a letter from God to get any help out of Guys outside of the appointments they give you which are months apart no matter how hard you beg - believe me I have begged to no avail at which point I had to see Mr Lam privately and pay for those injections. |
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2004-05 After 12 yrs of serious competitive sport, degeneration and tears L5/S1 and L4/5. 6 wks off work and went back p/t only. Told too young for surgery at 31 and that it probably won't help 2005-09 Dorsal root ganglion/steroid injections, amitriptyline, physio, osteopath, pilates and swimming 4 times per wk, back to working f/t 2009 Pain worse, saw Mr Lam at Guys. MRI: further degeneration in both discs and tear in L4/5. Discogram May 2009 14 Jan 2010 ADR L4/5, fusion L5/S1 by Mr Lam | |
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| Lynda | 28 May 2010, 10:39 PM Post #19 |
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Mrs R, how are you? Are you finding the Diclofenac helps your pain? |
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May 2008 onwards - Lumbar facet injections - First post-op ones four years post surgery, have lost count of the number I've had since then but they do help. Pre-op they didn't make much difference- Mr Shackleford, Warrington Feb 2008 - Cervical TDR, (Activ C's) C5/6 & C6/7- Mr Shackleford, Warrington May 2006 - Craniotomy and resection frontal lobe brain tumour - The Walton Centre for Neurology and Neurosurgery Feb 2004 - Lumbar TDR, (ProDisc's) L4/5 & L5/S1 - Mr Shackleford, Warrington | |
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| Mrs R | 29 May 2010, 12:55 PM Post #20 |
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Hi Lynda thanks for thinking of me. I think it has taken the edge off the pain slightly but it is very marginal. One good thing though is that I've realised the left heel pain I have is not nerve related. I think my plantar fascitis has come back as the diclofenac is really helping my heel, I can tell when it's wearing off. So that is one less pain to deal with at least. Am seeing Mr Shackleford on Tuesday so will report back. Was quite alarmed when I got the copy of Mr Lam's letter to my GP describing the proposed surgery. It seemed to have gone from keyhole surgery on the facet joints to "also a posterolateral fusion" which was never discussed in the appointment. I rang up and asked could I see him again to get more explanation but so far, no appointment, big surprise. |
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2004-05 After 12 yrs of serious competitive sport, degeneration and tears L5/S1 and L4/5. 6 wks off work and went back p/t only. Told too young for surgery at 31 and that it probably won't help 2005-09 Dorsal root ganglion/steroid injections, amitriptyline, physio, osteopath, pilates and swimming 4 times per wk, back to working f/t 2009 Pain worse, saw Mr Lam at Guys. MRI: further degeneration in both discs and tear in L4/5. Discogram May 2009 14 Jan 2010 ADR L4/5, fusion L5/S1 by Mr Lam | |
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| ajj1001 | 29 May 2010, 01:22 PM Post #21 |
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I've had plantar fascitis on and off (mainly when doing alot of running training) I have been seeing a podiatrist for treatment which has really helped. The next step (excuse the pun) is to have steroid injections in it if it doesn't settle a bit more. The fusion I have had is a posterolateral one, its not that huge an op but the recovery is the same as any annoying fusion op. Hope you get some good ideas and things cleared up on Tuesday. |
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Std Meds Gabapentin, MR Tramadol, Paracetemol, Laxatives 2011 Sept PLIF L4 - S1 2010 May Discogram L2/L3 & L3/L4 both looking ok. 2009 May PLG Fusion L5/S1 Charite in situ April Dismissed 2008 Caudal Epidural failed to work 2007 Deterioration L5/S1 Facet arthritis, Loss of disc height. 2004 Returned to Work 2002 Aug - physio March 2 level ADR Charite L4/5, L5/S1 2000 Broadbased disc prolapses L4/5, L5/S1 | |
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| Lynda | 29 May 2010, 01:47 PM Post #22 |
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It's good that at least some of your pain has diminished Mrs R. Personally, I found/find slow release Diclofenac very effective, (Voltarol Retard) its a once a day 100mgs tablet and, for me, is more effective than 50mgs of the enteric coated tablets three times a day as there are not the same peaks and troughs as the enteric coated. It also meant I could take an extra 50mgs a day if the pain increased. (150mgs is the maximum daily dose). I know everyone is different and it can be trial and error to find what suits best but it may be worth considering if you continue with the medication? I do know you have been prescribed suppostories; I was told by my pain doc that the side effects were the same no matter which route it is administered. Please don't be alarmed by the copy of your GP letter, sometimes the medical terminology can be confusing; a posterolateral fusion can be done with a minimally invasive approach and the instrumentation (rods/screws or whatever) can go through the facet joints so it very likely relates to the procedure discussed at your consultation. Perhaps you could discuss the option with Mr Shackleford for reassurance when you see him next week? Have you considered emailing or writing to Mr Lam for clarification rather than trying to get an earlier NHS appointment? I do hope all you need is more time for all this to settle Mrs R and that things improve for you in the near future. Kind regards Lynda |
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May 2008 onwards - Lumbar facet injections - First post-op ones four years post surgery, have lost count of the number I've had since then but they do help. Pre-op they didn't make much difference- Mr Shackleford, Warrington Feb 2008 - Cervical TDR, (Activ C's) C5/6 & C6/7- Mr Shackleford, Warrington May 2006 - Craniotomy and resection frontal lobe brain tumour - The Walton Centre for Neurology and Neurosurgery Feb 2004 - Lumbar TDR, (ProDisc's) L4/5 & L5/S1 - Mr Shackleford, Warrington | |
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| Mrs R | 29 May 2010, 04:54 PM Post #23 |
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You are both very kind. I do have orthotics for my shoes which cured my plantar fascitis before when I had it years ago (also when doing a lot of running) but I'm still looking for them in the house! I wonder if my gait has changed since the op, in fact I'm sure it has because I feel so much more stable across my hips when I walk, and maybe that's why it has come back. Hopefully it will clear up. I've really been pounding the pavements since the heel pain went, walking up to 2 hours a day over 3 separate walks. Takes my mind off things but it can flare the pain up a bit. Thanks for the reassurance about the posterolateral fusion. I saw a few diagrams of metal rods etc on the web when I searched which scared the life out of me! |
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2004-05 After 12 yrs of serious competitive sport, degeneration and tears L5/S1 and L4/5. 6 wks off work and went back p/t only. Told too young for surgery at 31 and that it probably won't help 2005-09 Dorsal root ganglion/steroid injections, amitriptyline, physio, osteopath, pilates and swimming 4 times per wk, back to working f/t 2009 Pain worse, saw Mr Lam at Guys. MRI: further degeneration in both discs and tear in L4/5. Discogram May 2009 14 Jan 2010 ADR L4/5, fusion L5/S1 by Mr Lam | |
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| Gilly | 30 May 2010, 01:11 PM Post #24 |
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Hi Mrs R I am so sorry that you are having to go through so much more than was originally expected and hope that your appointment with Mr Shackleford goes well. He is a brilliant man to talk to and I am sure he will be able to reassure you. Its good to know that one problem has been solved for you at least and that you have been able to get some walking done. That is good going and I am sure it will take your mind off things and make you feel better that you are able to so something positive. I find any exercise I am doing flares up the pain, even the swimming and especially the physio, it is a very slow process!!! :rolleyes: . At least it is keeping you fit whilst you get some more answers as to the next step for you. Thinking of you and good luck for Tuesday. Love Gilly xx |
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1990 MRI - disc protrusions levels 4/5 - fusion offered but declined due to poor prognosis. 2007 MRI - disc protrusions Level 4/5 level5/S1 2010 2 level lumbar ADR Mr Ian Shackleford Warrington General 2010 MRI - disc protrusions at levels C4/5 C5/6 2011 27 June 2 level Cervical ADR Mr S at Spire (on NHS) | |
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| Mrs R | 2 Jun 2010, 02:54 PM Post #25 |
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Thanks Gilly. It's good to hear that you've been doing some swimming. I wish I could! Just back from my trip to see Mr Shackleford and he basically agrees with Mr Lam. In fact he would favour a slightly bigger op - not doing the surgery as minimally invasive and doing a nerve decompression at the same time so as to try and cover every single factor which could be causing my leg pain. He said the same as Mr Lam about the chance this will help me - from what I understand I think it is so uncertain as to be unquantifiable. Going to have a serious think and may possibly even get a third opinion, if I can face it. They always tell you to get 3 quotes if you're having work done in your house so I reckon having work done on your spine deserves at least the same. |
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2004-05 After 12 yrs of serious competitive sport, degeneration and tears L5/S1 and L4/5. 6 wks off work and went back p/t only. Told too young for surgery at 31 and that it probably won't help 2005-09 Dorsal root ganglion/steroid injections, amitriptyline, physio, osteopath, pilates and swimming 4 times per wk, back to working f/t 2009 Pain worse, saw Mr Lam at Guys. MRI: further degeneration in both discs and tear in L4/5. Discogram May 2009 14 Jan 2010 ADR L4/5, fusion L5/S1 by Mr Lam | |
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| ajj1001 | 2 Jun 2010, 03:53 PM Post #26 |
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Sorry its not better news. Unfortunately if those two consultants agreed I would go with whatever they said. Just my opinion so I'll be there to support you any way possible if you go ahead and get another opinion. I would have no idea as to who to suggest might be any better. |
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Std Meds Gabapentin, MR Tramadol, Paracetemol, Laxatives 2011 Sept PLIF L4 - S1 2010 May Discogram L2/L3 & L3/L4 both looking ok. 2009 May PLG Fusion L5/S1 Charite in situ April Dismissed 2008 Caudal Epidural failed to work 2007 Deterioration L5/S1 Facet arthritis, Loss of disc height. 2004 Returned to Work 2002 Aug - physio March 2 level ADR Charite L4/5, L5/S1 2000 Broadbased disc prolapses L4/5, L5/S1 | |
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| Mrs R | 2 Jun 2010, 04:27 PM Post #27 |
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Hi Alison I'm not really looking for someone 'better' but just a different perspective. If Mr Lam could even tell me it was likely to help me I would do it. Problem is they just don't know if it will help or not as it's no clear what the problem is. Seems like the posterior surgery is technically the only thing left they can do and it may help, or it may not. Having been made worse by the surgery I have already had I am not keen to risk that again. All my instincts are saying don't do it, but I'm not sure I can carry on like this. |
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2004-05 After 12 yrs of serious competitive sport, degeneration and tears L5/S1 and L4/5. 6 wks off work and went back p/t only. Told too young for surgery at 31 and that it probably won't help 2005-09 Dorsal root ganglion/steroid injections, amitriptyline, physio, osteopath, pilates and swimming 4 times per wk, back to working f/t 2009 Pain worse, saw Mr Lam at Guys. MRI: further degeneration in both discs and tear in L4/5. Discogram May 2009 14 Jan 2010 ADR L4/5, fusion L5/S1 by Mr Lam | |
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| Mrs R | 2 Jun 2010, 04:30 PM Post #28 |
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Oh BTW, Mr Shackleford suggested Arcoxia would be less detrimental for the fusion growth than Diclofenac. |
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2004-05 After 12 yrs of serious competitive sport, degeneration and tears L5/S1 and L4/5. 6 wks off work and went back p/t only. Told too young for surgery at 31 and that it probably won't help 2005-09 Dorsal root ganglion/steroid injections, amitriptyline, physio, osteopath, pilates and swimming 4 times per wk, back to working f/t 2009 Pain worse, saw Mr Lam at Guys. MRI: further degeneration in both discs and tear in L4/5. Discogram May 2009 14 Jan 2010 ADR L4/5, fusion L5/S1 by Mr Lam | |
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| dillie | 2 Jun 2010, 04:58 PM Post #29 |
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I would check contra-indications with Arcoxia, sorry Mr S....!! There was a bit of contraversy about that group of drugs a while ago. I was put on it after my Dynesys op in 2004 and at first all was well but then the inside of my mouth was showing bruising and soreness which the pharmacist said was probably happening throughout the whole digestive tract so I had to come off it. Not everyone will have problems I know but I would do a bit of reading up first. Forewarned is forearmed?! Wishing you all the best for your forthcoming treatment Mrs R and hope things will soon be better for you. |
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| dalhousie | 2 Jun 2010, 08:13 PM Post #30 |
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I've no pearls of wisdom but just thought I'd add some support. It must be very difficult to be faced with such an agonising decision after 2 well respected opinions. Like Alison I wouldn't know who else to see who is on a par with them. Hope you find an acceptable solution to your dilemma. xx |
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2005 Anterior fusion L1/2 with BMP & floating rib removed. 2009 ADR (activ L) L4/5. 2010 Chronic pain from Facet Joints T10-L2 with lots of muscle pain 2013 Attended Walton PM Programme: not much help. 2014 Chronic Pain - Facet Joints L4-S1 2017 Nevro SCS for thoraco-lumbar & lower lumbar facet joint pain | |
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