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Scott Durham
Oct 17, 2006 - 7:08PM
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HELP!!!!
I had an MRI 10-16-2006 and the radiologist told me and my wife that I had 4 definite herniated discs in my lower back and 1 possible. Today, the Orthopedic specialist that I had been seeing called and said that he had revieved the MRI disk and that I only had 1 herniated disk and that was normal for someone my age, 25. So my question is I am experiencing SEVERE pain in my lower back, often times can't sleep even through strong pain meds(percocet 10/325). Does anyone have any ideas about what this might be? OR what I should do? My primary care gave me a referal to Pain Management but has anyone else ever had two doctors give them two different diagnosis'? I guess I am just confused on what to do next. HELP! I felt when the Orthopedic called that my back wasn't a big deal to them but I am in SEVERE pain.
SMD
bulldurham1981
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Tom
Oct 17, 2006 - 9:11PM
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Re: HELP!!!!
As you've probably heard, MRI findings don't necessarily relate to pain. I've been in constant pain for the last 5+ years, yet numerous MRI's, Xrays, CT, films show nothing out of the ordinary.
What does the MRI report show? That's the radiologist's interpretation of the film. Before the ortho suggests any surgery, he would do a discogram to determine the pain generator. If positive, he/she MAY suggest surgery. If inconclusive, any reputable surgeon will suggest other non-invasive courses of action (PT, stretching, etc).
Hang in there... if the severe pain doesn't radiate to your legs, you're probably not a surgery candidate (that's a good thing).
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news4u
Oct 18, 2006 - 9:35AM
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Re: HELP!!!!
Hello Scott,
I felt a bit confused too about your dilemma. Let's review this:
You say you had an MRI done on Oct. 16th and that the radiologist said one thing.
You say you had been seeing an orthopedic surgeon and that he said another thing (apparently about the same MRI that the radiologist looked at), and normal to your age, yet you're still in severe pain.
You say your primary care (doctor) referred you to pain management (I think a good thing).
At first, I didn't know what this might be (causing your pain) and thought that the situation sounded somewhat strange. Then I looked at it again.
The views of the radiologist and the orthopedic surgeon, at first glance, seemed to be different. And you said that they appeared to differ in their diagnosis. They have agreed, though, that the cause of your pain is herniated disk(s). The issue is how many. It's the same diagnosis...just a discepancy as to how many herniated disks.
Maybe you could take a very close look at the MRI together with your primary care doctor and come up with a definitive answer as to how many herniated disks there really are and where they're actually located (see the pictures with that doctor together and ask questions, get answers, and an explantion (i.e. human error?). This would also help to ensure that it's your MRI that was being looked at by the other two professionals. I believe that once you know how many herniated disks and where they are located, that's the start to getting you in the right direction to FOCUS NOW ON THE SOLUTION.
I also suggest that you do an internet search on "herniated disks" (two professionals are actually agreeing that that's the cause of your pain).
The pain management in the meantime sounds like a good idea. As to the herniated disks, at least you know that's the cause.
Armed with information from the website about that subject, you would feel more informed and empowered. You would be taking a pro-active approach to your healing in dealing with the pain through pain management as well as getting informed about the herniated disk(s) and what could be done to treat that underlying cause of the pain.
There are three things here: the pain, the cause of the pain (herniated disk(s), and the remedy for both--a whole body approach.
Sounds like your primary care doctor is the best source to deal with the issues from a centralized position. Otherwise, you're getting bogged down in the superfluous (extra) issues (the discrepancies between the other two professionals' views as to how many herniated disks). STAY FOCUSED...it's about herniated disk(s) and the pain being caused by it / them.
Hang in there...you're on the right track...I think you just needed first to get past the confusion...which is what I've tried to do here.
Also, seeing as you're on the Lose the Back Pain website on this post, you might also want in the meantime to learn about herniated disks from this website (click on "Return to Website" at the top of this page--a couple of sentences down--and you'll find several links to articles at the bottom of the website about back pain subjects), talk with your primary doctor about that information, and whether or not he /she thinks that exercises might help (the right ones specific to your condition).
Best Regards,
news4u
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Scott Durham
Oct 19, 2006 - 12:25AM
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Re: HELP!!!!
Thank you so very much!!! I know when I reread the post it was very confusing to me also. I just really didn't know the next step and you helped me with that.
I also wanted to add that when my primary care looked at the MRI disk, he said my back looked "nasty." Those were his exact words. That's why when the Orthopedic called and said that I didn't need to come back to follow up with him because I only had 1 herniated disk it didn't make sense but now it is starting too.
I think that Orthopedic specialists focus on the very bad cases, that require surgury after reading quite a few articles on the internet, so that explains why he made lightly about my situation.
I have an APPT on friday, Oct 20th with Pain Management so when he looks at the MRI disk he should be able to clear it up. I just wonder how 2 specialists would say 2 different things but my primary care would go along with the radiologists by claiming by back looked "nasty". Anyone have any suggestions on some things I should talk to the Pain doctor about? Or if I should try different meds(I'm on Percocet 10 for pain right now and valium 10 for muscle relaxation)? Thanks in advance, you really did help me sort through a lot of my confusion, hopefully this post makes more sense.
SMD
bulldurham1981
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news4u
Oct 19, 2006 - 12:51PM
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Re: HELP!!!!
Hello Scott,
I'm very glad to hear that some of the confusion was sorted out, that the information provided to you was helpful, and that you're going to pain management.
People look at things in different ways. You could put five (5) people in a room. Tell them the very same thing by enunciating your words very slowly and very clearly when everybody's together in the room. Then ask them, one by one, for their interpretation of what you said. You may be surprised at the answers you hear--even though you said the very same thing to all of them and at the same time. That's because people, all being unique individuals, may think and hear / listen differently (also the tone in your voice would be picked up too). Hence, that's how communication problems often happen and / or arguments founded on people's individual perceptions (the way they see things). Not one person is right or wrong...it's all in the interpretation...and people come away with what works best for themselves. It's human nature.
I think that your primary care doctor did you a good thing: he said your back was, in his view, "nasty" and it seems that it was he who recommended the orthopedic specialist (a surgeon--in the event of a worst case scenario...a PERCEPTION...and an ASSESSMENT was made based on that perception). Your having then got the opinion of the orthopedic specialist, this doctor, I think, actually helped you. He was saying that he wasn't in it for the money...he knew that surgery is a last resort...and he was indirectly saying to you that in his view you didn't need surgery. It didn't mean he didn't care. He was just giving you his opinion based on his perception and assessment as a trained specialist in his field. Surgery should, I think, only be a last resort. I think that most reputable doctors would take that position too--what they think is best for the patient. The patient alone, though, is responsible for making the choice. You could always get a second opinion if you wanted but I think you're on the right track.
Mainstream medicine approaches usually consist of:
anti-inflammatories
muscle relaxants
pain killers
physio therapy / massage
pain management
(orthopedic) surgery (last resort)
Pain Management:
Whatever questions you can think of, after having done your research on the internet, are the questions you should ask. Anything that is of concern to you are the questions that you have a right to have answered and in a way that you can understand so that you can make informed choices about yourself and for you.
Go into the appointment with the attitude that you're not helpless, but empowered by information, and looking to be related to by the 'specialist' on an equal basis on a people-to-people level. They aren't responsible for you--they're responsible for giving you the benefit of their training to help you get better--that's what they're paid to do...and you make sure you get your money's worth, okay? (in a nice way...be assertive). Work with them and they'll work with you...about you...and for you.
As an added note, if it was me going to that appointment (and putting myself as best as I can in your shoes for a second) I'd do this:
1. ask to look at the MRI together with the pain specialist.
2. ask him to show me EXACTLY on the picture what he's talking about (show me where the pain's coming from and what the herniated disk(s) are doing that's causing me the pain)
3. ask any questions that came up from that and get answers that I can understand so that I know EXACTLY what the person is talking about so that we can 'talk' on the same level...one person to another
4. ask how the pain management would help the affected area (it probably won't...it's probably just what it says: PAIN MANAGEMENT...to manage the pain...to help reduce it / eliminate it...to get you functional...until the pain subsides and / or goes away. Then treatment for the underlying cause (the herniated disk(s)) can be undertaken...(another step...and probably another approach and / or by yourself or with / through your primary care doctor)
5. what strategies does that specialist have in reducing / eliminating the pain (and if I wasn't comfortable with that, I'd ask for alternatives to that person's ideas until both he and I could agree on what's best for me in terms of what I feel comfortable with)
6. how many herniated disks are there?
7. where are they located (show me on the picture)
8. where are they located (show me by touching that area on my back)
9. do muscle imbalances show up on the MRI? If so, are there any? Where are they? SHOW ME (i.e. the foundation of LTBP system's approach to healing back pain on a long term basis through targetted exercises...inotherwords looking ahead to see if LTBP system would work for me).
Oh, okay, now I get it (I'd say to myself)!
And I'd undersand EXACTLY what's happening and why. I'd also be making my own choices based on the information I got from the pain management specialist AND from the answers to my questions put to him.
I'd also ask MYSELF if the currently prescribed pain killers are working for me, at least to some degree, and if not I'd ask the pain management specialist to suggest something else for me. Then the question becomes TO BE ASKED OF THE PAIN MANAGEMENT SPECIALIST, "are there any side effects (and, if so, what are they?" "is it possible to become dependent on the medication?" and, if so, "would there be withdrawal symptoms at some point when the pain is reduced and / or is gone" and "what does a person do about that?". I know, then, that I'd have to make a choice by weighing the pros and cons. (Only you know your medical history...you don't want to be prescribed something that might cause heart problems in somebody who's got heart problems, for example that a specialist might not have thought about but you have information about...about you...and for you).
There's a post on this discussion board about a painter who is on pain killers from a pain management specialist. Without them, he says he couldn't function. Somebody wrote that he seemed addicted to them. Another person wrote that there's a difference between being dependent on them (for survival) and being addicted as such. You might want to read the post. The caption at the moment escapes me.
There's another post on this discussion board (Aug. 22 / 06) about a pain management specialist having prescribed "Duregesic Transdermal Fentynl patch". That post says that the patch is worn 3 days at a time and it releases through the skin (takes about 12 hours to kick in). The person writing the post says that it's VERY powerful stuff, to start with lowest possible dose that works for you. You could check out that post. I don't remember off hand what that person's cause of his pain are and don't know, off hand, if it would apply to you so you might want to check that out directly. I also don't know the degree of your pain, Scott, but you could ask about this patch with your pain management specialist (including how much it might cost, any side effects, dependency / withdrawl issues, etc.) and get all the answers to any questions...and I mean ANY...that come to your mind as you talk with him. Remember that this is about you and for you.
No question is trivial when it's about your healh and wellbeing and you have the right to get them answered and in a way that is understood by you so that you can take responsiblity for making the RIGHT choices...for you.
Also, seeing as you're on the Lose the Back Pain website, once you've got your pain subsided and / or its gone, you'll have to look at what to do about that / those herniated disk(s). At the moment, getting that pain under control is the focus. It might be that the LTBP system might work for you in dealing with the herniated disk(s) and in a natural way through exercises...the RIGHT ones for you and that's something you might want to talk about with your primary care doctor at some point. You could discuss it by bringing in any material you might have gotten on herniated disks and muscle imbalances and how the LTBP system might help with your specific situation once the pain caused by the herniated disk(s) is under control.
The issues:
1. the pain and its management
2. the underlying cause of the pain(herniated disk(s)
BOTH have to be treated...the body has to be viewed as a whole.
Best Regards,
news4u
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news4u
Oct 19, 2006 - 1:23PM
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Re: HELP!!!!
Hello Scott,
PS--I came across the following website that you might want to check out:
http://www.glofin.com/herniated_disc.html
It talks about herniated disks / treatment (including the apparent most recent one of electro shock wave therapy (sounds scary) / pain management there.
In particular, please note what it says about pain management. It might give you something else to think about and ask about at your pain management specialist appointment.
Always remember that the LTBP system is available to you to treat that / those herniated disks.
Keep all your options open. Make informed choices.
Best Regards,
news4u
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David
Nov 7, 2009 - 10:54AM
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Re: HELP!!!!
Why do doctors refuse to give pain medicine to people
that are in pain. Doctors are to worried about addiction and not the people pain. Why!!!