Wellness

[Mindy D]

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@sfnative wrote:

Hi Everyone,

Not wanting to burst into the really fine on-going thread on sciatica, I felt expressing my need separately would be best.

My sciatic event began at the conclusion of doing dinner dishes on May 20th.  The pain has been excruciating and complex.  From the initial turn away from the sink, a sharp pain around L4-5. along with horrid muscle spasms (paraspinals I'm guessing) on a trajectory up from L4-5 for about 12 cm, including mid-glut pain shooting down to my heel.  All of this occurred at the same time.  I froze in pain.  Couldn't move.  This hasn't stopped.

Knew I had to wait the prescribed 6-8 weeks to determine if "things would settle down."  Nothing settled down.  Not only that, but one month later, while making a tuck in bed linens for my paralyzed left foot and toes, had horrid pain lacerate from mid-glut down to the "privates" area on the right.  Last week tingling settled into the gluteal fold.

Not returning to the ortho-spine I saw 18 months ago. She dismissed me with a "So sad, too bad."

Found well-recommended neurosurgeon at very comprehensive practice, where my hand surgeon is.  Have an appointment with his nurse practitioner this coming Monday the 19th, just to get me in, have films taken and get MRI/CT, then I'll see Dr. N.  (Have had to wait nearly 3 months for just this appt.  No, can't go to E.R.  Here, we have two Level 1 E.R.s: one is for trauma only and the other for "sick" only.  I don't qualify for either.

Am asking, please, for prayers or kind thoughts.  I not only need a solid diagnosis, but an aggressive treatment plan, as I'm way beyond PT/massage.  Am fearful, at this stage of losing bladder/bowel control.

Thank you, everyone.

XXX ~ Rebecca

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A temporary fix, I know, but how about muscle relaxers for a week. Hard to get, but SOMA might help. Any of the other muscle relaxers might help, though they’re not as effective as SOMA, but they are easier to get;  or try using Diazepam instead, due to its muscle relaxant (I know it’s a benzodiazepine, but it really helps relax back muscles.) effects. Sorry you can’t take NSAIDs. I’d be worried about cauda equina syndrome too. Imaging is a priority.

[cherry]

In the words of Padre Pio pray, hope, don't worry...in the words of Christ ,where ever  2 or more are gathered together in my name, there am I in the midst of them

May all that are suffering find a blessing  and a healing

[Still Raining]

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@sfnative wrote:

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@Still Raining wrote:

There are indeed two Level 1 trauma centers in Portland - OHSU and Legacy Emanuel.  

As part of their licensing requirements there must be certain specialists on-call including neurologists.  In addition they also must treat cases of lower acuity.  They also accept life flight.  No one can be turned away for payment issues.

Neither is designated trauma versus sick.  Although I think Legacy is Level 1 for pediatric cases in spite of OHSU having Doernbecher.

Might be worthwhile to check again.

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@Still Raining 

OSHU is just too far from our house, as we're in N.E. near Rossi Farm and 10 minutes from the Michael's store off of Airport Drive.

Providence takes only "Sick."  I did go to Legacy with that horrible foot injury on Day 2, but was pawned off on a third rate podiatrist.

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Yes, Providence has no Level 1.

Since Providence accepts Medicare they must conform to EMTALA in all their EDs.  As such they must consider sudden severe pain (among other things) an emergency and triage/treat the patient.

There is no classification of “sick” in licensing or in EMTALA.

After triage the patient may be turned away for drug seeking or not actually being in an urgent situation.  Is this what you mean by “sick” only in the ED?  Not making the cut?

If so, then you were not eligible for the ED and should have gone to find other care.  Or else get a lawyer.

[Skyegirl21]

Rebecca, please keep us posted- I hope you feel better soon (and NO other symptoms). 💐🙏

[sfnative]

@Mindy D 

Hi Mindy,

Prior to and following my fusion at L5-S1, my surgeon prescribed SOMA and I found it effective.  However, it's no longer performing as it did in 2012-13.  Perhaps something will come out of my appointment tomorrow.  Am sure hopingg so.  Thanks, just the same, for kindly thinking of a muscle relaxant, for I know i'd benefit from one.

A huge problem where I live is that the state keeps a close tally on what meds everyone is on.  This limits physicians in what they can prescribe, because if a patient is, say, on a pain med, an anti-anxiety med and perhaps other necessary meds that fall into the class one category, that patients is not going to get the muscle relaxant, because too many drugs are already being prescribed.  What they've done is to bunch all of the sick, needy patients in with the drug addicts.  Truth!

[sfnative]

@Still Raining 

It was a Friday and I knew Legacy would be jammed.  Providence had more than their share of people in the waiting area who will ill and while I was there, rescule showed up with 2 cardiac arrests.  MIs are brought to Providence.

Anyway, it was clear they had no intention of treating me.  They just wanted me gone, so just gave me oxy and got me out of there.  I know how this works.  I was an RN years ago, then Head/Surgical Training at a large medical school/clinic/hospital complex, with years of ortho experience, as well.

[sfnative]

OP here - Hi Everyone,

I need to make a list of all of you wonderful ladies who are so supportive and praying for me.  You have no idea how moved I am.

Please know that the time I can spend on my laptop is very limited.  I can only sit and write for maybe 10 minutes, then the pain is too much.  So, I'll come on a few times a day, just to make sure I'm touching base.

Love you all...Now I'm headed into the master bath.  Decided I need to put a small purple streak in my hair...so here goes.

God Bless you all ~ Rebecca

[Trinity11]

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@sfnative wrote:

@Mindy D 

Hi Mindy,

Prior to and following my fusion at L5-S1, my surgeon prescribed SOMA and I found it effective.  However, it's no longer performing as it did in 2012-13.  Perhaps something will come out of my appointment tomorrow.  Am sure hopingg so.  Thanks, just the same, for kindly thinking of a muscle relaxant, for I know i'd benefit from one.

A huge problem where I live is that the state keeps a close tally on what meds everyone is on.  This limits physicians in what they can prescribe, because if a patient is, say, on a pain med, an anti-anxiety med and perhaps other necessary meds that fall into the class one category, that patients is not going to get the muscle relaxant, because too many drugs are already being prescribed.  What they've done is to bunch all of the sick, needy patients in with the drug addicts.  Truth!

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Yes and exactly why I never took Tramadol for my sciatica. I knew it would be difficult to get it down the road, so I used Tylenol Extra Strength through this whole ordeal. Even with the Tylenol, I do see when I stop taking it for at least 12 hours, it works more efficiently to relieve pain.

I think I turned a corner the past few days. I was able to sleep a few hours and am no longer in agony. I hope and pray @sfnative that you will be feeling better in the next few days. Please keep us posted....

[Mindy D]

Epidural steroid injections. Of course you need imaging first.

On the efficacy, “In general, patients who have had symptoms for less than 3 months have response rates of 90%. When patients have had radiculopathy symptoms for less than 6 months, response decreases to approximately 70%. Response decreases to 50% in patients who have had symptoms for over 1 year. Patients with symptoms of shorter duration have more sustained relief than those with chronic pain. Patients with chronic back pain generally have better response if they develop an acute radiculopathy. Patients with factors favoring the use of ESIs also include those who have not had previous back surgery, who are not on workers’ compensation, who are aged younger than 60 years, and who are non smokers.”

quoted from Medscape 

“Factors affecting the efficacy of ESIs”

[sfnative]

OP Here - Hi Everyone!

It's just after 2:30 p.m. here on the west coast and I just returned from my appointment.  Here are the results of my meeting with Dr. N's Nurse Practitioner, Jennifer:

A/P and Lateral x-rays of my lower spine were taken.  My 2012 fusion at L5-S1 is patent, with absolutely no issues associated with it.  The disc space at L 4-5 is ridiculously narrow.  Ascending disc spaces are narrow as well, but not as bad as L 4-5.  The films did not indicate anything overtly wrong, with the exception of a very slight forward displacement of the L4 vertebra.

Next step is an MRI some time this week or beginning of next week pending insurance approval, which will not be an issue, just the time it takes for this to occur.

My pharmacy is processing prescriptions for Gabapentin, a Medrol Pack, and Oxycodone increased by 5mg (when I need it).

Once the MRI results have reached Dr. N, I will be called and an appointment will be made for me to consult with him (Yay!).

So, that's the sum of today.  I am very pleased with the results of meeting with NP Jennifer and my experience with this new and comprehensive practice.  I'm very grateful that Jennifer took a good read of me and prescribed the meds that she did...so very grateful.

And, the thing I'm most grateful for today are all of you and your prayers, kind thoughts for me and holding me up, as I traverse all this pain, along with chronic migraine.  It's been a physical and mental trial since May 20th and I'm so glad I reached out to all of you.  What a blessing, indeed!

You are my rock stars!  And, as the old song goes, I have "joy, joy, joy, joy down in my heart."

XXX ~ Rebecca