Worker's Comp-Post Surgery L5/S1

[RhondaDanielle]

I'm 34 and feel like I'm 80!! To be brief.... my L5 disc broke in half and pinched my S1 to the point where my right leg and foot were numb and my rt calf was near unusable. I had the half of the disc that was pinching the S1 removed on 10-15-05 and the other half was left in. I received extreme relief from the surgery!

My grievance is, although I have regained muscle control in my rt calf, the calf muscle is still, to this day, so sore and extremely tight, despite taking anti-inflammatory & muscle relaxers,(Tramodol & Etdolac) aswellas stretching it on my stairs each day, that i can't even bare to massage it without bringing tears to my eyes. Also, I have muscle spasms continuously daily, but the ones I'll get at night that wake me straight from the dead, are so excruciating, I sometimes feel I may need to call 911. (which has not come to life as of yet)I received Gabapentin for the spasms around 6 months ago and see no effect.

Additionally, even though I received extreme relief from the pain of my S1 nerve being so tightly pinched, I still have chronic back pain. At times, I wake from my sleep feeling as if my back is "frozen" in place and I almost need assistance to slowly start to gain mobility. (I have tried all different sleeping positions and mattresses) I had a post-op MRI which my doctor said showed no signs of the other half of my disc slipping.

My doctor states that these things take time to heal and to continue with my medication, it could take years to fully recover. He did refer me for massage therapy which was denied by my employer due to the fact i continue to work and my pain is tolerable with my medication. (My doctor deemed me permanent & stationary on 7-06 and stated I could not return to my Banquet Serving position and needed to find another occupation. I voluntarily returned on modified duty 9-06 and am currently still there.)

My questions are...... (1) am I not getting the recovery care and therapy I require due to my injury being a work comp injury?? If so, how do I know? I'm thinking any doctor I get another opinion from is going to be through my work directory of doctors to choose and they have some unspoken rule of down-playing severity or treatment necessity.

(2) Is it common for recovery to take years and have to stay on all these medications to tolerate the pain until I eventually do improve or it becomes debilitating?

(3) Although I voluntarily returned to work on modified duty, I feel I'm doing more harm than good, but am unsure due to the fact my back aches if I stand too long, sit too long, or walk too long.

(4) I am SOOO DEPRESSED LIVING LIKE THIS EVERYDAY, and I am (sick of being sick). I used to work out, play volleyball, play with my kids, etc...., I don't even recognize myself anymore. PLEASE....Lead me in the right direction with any wisdom or references you may have out there. Thank you so very much for your time!!! ~Rhonda~

[Harrison]

Rhonda, sorry for the delayed response. It sounds like you had discectomy, and there is still some instability or nerve compression happening. Can you tell us a little more about your surgical procedure? And how did your surgeon communicate/set expecations about your procedure? What next steps might you have lined up with other medical professionals?

[RhondaDanielle]

Thank you so much for responding!!!!

I'm feeling a sense of relief just finding this forum in hopes I can educate myself through other's unbiased opinions and experiences.

Yes, I did have a disectomy. I had only half of it removed. My doctor did inform me of the slow recovery process,but being a year and a half after surgery, I am concerned and frustrated.

I just recently convinced him to refer me to the neurologist, due to my calf not improving and being so painful. The results came back abnormal, and he refered me for the therapy which was denied. Every visit I let him know how I'm doing the same still, he tells me, he's expecting a good outcome which could take years and to stay on my medications.

I have an appointment with him on Tuesday. I just started doing research and I am reading these things, like "Yes" that's me and "Yes" that's what I'm trying to explain in my laymen terminology about my pain and continued episodes with my back and calf. I was reading about lactic acid and myfascial release and nerve compression like you mentioned. This is what I have or am experiencing!!!!! I can't imagine I am just expected to live like this for years until it improves.

What I am proposing to say to my doctor is, "I have found this information that sounds like what I have been trying to convey to you each visit." I want to say, I need a second opinion because I cannot live this way any longer just being told to take my meds and be patient.

What actions should I be taking without seeming unreasonable or impatient?? I am no baby by any means and can handle discomfort and pain. What I am experiencing, I am reasonably sure, is not within the normal ranges expected to be tolerated while recovering, if I am even doing that. Any advice or suggestions?? Thank you so much for your time!!

~Commit random acts of kindness~

[Can\'t_Sit]

I agree that you shouldn't be on your meds for that long but I have read that doctors don't take well to "I've found this on the internet and this is what I have". It's not scientific enough for them and they get defensive.

The best way to approach it is to be quantative. Tell him exactly how long you can sit/walk/stand. Where you have the pain and on a scale of 10 how much that pain is. How far you can bend before the pain starts. Where it hurts to touch on your body. Etc....

Then let him come to a conclusion himself/herself and if it doesn't match what you've read. Say that you've "done some research" and you think you match closely to these symptoms. If s/he disagrees, then say you want a second opinion.

Don't let his/her ego get in the way of your diagnosis.

[Harrison]

Rhonda,

Paula offers some nice points to consider. Clearly, you need to take the necessary steps to obtain an accurate diagnosis. So, you’ll need to find a good orthopedic doc or neurosurgeon. We’ll try to help you find one; but in the meantime, please update your profile (to include your city and state) and a signature (that best describes your spinal condition).

I’ll be back soon…

[RhondaDanielle]

Yes, Paula, you are right. I am going to write down and be very specific and be very detailed for tomorrow's appt.

As much confidence that I have in my doctor, I am finding it hard to come right out and say, I need a second opinion, but I am feeling more and more overwhelmed and depressed as days go by being farther and farther post-op, I am thinking there is no other choice.

One thing that has crossed my mind, since I am dealing with work comp is, going to my own doctor ( I have Kaiser) and having them test/diagnos me, and then bringing that information to my work comp doc. But I heard that since it is a work comp injury, kaiser would not cover that. Anyone know??

Harrison, thank you again!! Let's see what tomorrow's appt. has in store for me. I am going in optimistic for something more accurate, but am also prepared to more proactively help myself and seek out another doc!! Let's start researching San Diego area, smile.

<UL TYPE=SQUARE>Rhonda, 34 yrs old, San Diego, CA
MRI Sept. 05,L5/S1 Disectomy Oct. 2005, performed by Dr.Larry Dodge, San Diego Orthopedics, Meds, 3 Etdolac, Tramadol, Gabapentin since Oct. 05, Water P/T 16 weeks[/list]

[Ginny]

Hey Rhonda.

I figured I'd offer some suggestions, if you don't mind.

Have you had a physical therapy eval? My husband's pain kicks in at a 7 degree bend. It should be in your medical records somewhere.

As for the mattress, it took us years to find the right one for him. He uses the hardest we could find; its a Simmons. It's so hard a little boy jumped on the display model and hurt his nose!!! I use the softest. We put two extra long twins together and cover them with a king-sized fitted sheet.

As for sleeping positions, I use a fat pillow between my thighs and sleep side-lying. He mainly sleeps on his back with a foot up to keep his spine straight. On rare occasions, he'll try sleeping on his belly with one leg straight out and the other pulled up to his chest.

He tried most of the anti-inflammatory drugs out there with little help. He is currently on Mobic. He says that helps him because he gets "frozen" too. I worry because of the side effects. You've got to sit up for @ 45 minutes after taking it to decrease the risk for complications like performation of the bowel (or as I like to say: busted gut syndrome).

As for the calve pain, I don't know really. He gets calve pains, but he drinks tomato juice (guzzles it down really) for the potassium. He has to do this because the pain (along with other factors) made his blood pressure to high, so he takes a blood pressure pill which depletes the potassium from his blood. Hence, he drinks tomato juice to balance it all out.

I've notice with his worker's comp docs that they really don't pay attention to getting lab work ordered. Have you had a "complete metabolic profile" recently?

With my sciatica, I was informed to do yoga and and Qi Gong exercises. (Works even better when you TRY to make your belly button touch your spine, suck in the buttock cheeks, and pretend your trying to hold your urine. I thought they were nuts when they told me to do that but, it actually helps, although I am behind in my exercises. I was wearing a back brace (the first one was improperly sized), but they said to only wear it at work and to wean myself off it once my stomach muscles got strong enough to actually help my back.

As for getting a second opinion via worker's comp, we had to get a lawyer to help us fight for the "approval". Now, we may need to find a new doctor again...

Keep your chin up.

When our daughter was 6-7 years old, I was on crutches and John was just starting his postop physical therapy. She taught herself how to ride her bike by going down the slight incline on the side yard. We stood by watching.
But she has learned from us. She's 15 now, knows cpr, has a killer spiral when she throws a football (I taught her that!) and she's resilent and compassionate. Helps her handicapped grandmother grocery shop every other weekend and wants to be a doctor.

Know of any worker's comp college scholarships for the kids?

-ginny

[RhondaDanielle]

Ginny, the story of your daughter made my eyes burn!!

My surgery was Oct.15 and on Oct.19 my son was in a car accident. His birthday is Oct.20, in which he turned 16 in the ICU in Children's Hospital. He cracked his skull and had to have pins inserted throughout his right leg down and into the foot. (He 'was' a football player.) I am a single parent and was planning on him helping me with his brother 9, and sister 8. He told me a story of his little 9 year old brother standing in the kitchen making soup for him, that brought himself to tears.

I know children who have experiences like ours, grow to be extraordinary people!!

I will look into Yoga classes in my area.

Did you receive your back brace from your doctor to get the right size or ?
With your Sciatica, even when you feel no discomfort, can you push on a certain area in your back or leg and trigger or feel that nerve pain? I can, only on the rt side though, and am just wondering if this will always be the case.

How long did your husband have that frozen feeling before they gave him the Mobic?

I am concerned about being on all these meds for these long periods of time, not knowing what side effects they could be causing. I bought some potassium pills to take daily, but have not felt a difference. I hate tomato juice, but would drink it religously if it stopped the cramps and pain!!

After my surgery, I contracted pseudonomis and later on MRSA,(as well as a fungus infection) I don't know how I actually got these two diseases, but I have been on more medications and iv's in the last year than anyone in a lifetime should be. I will ask about a complete metabolic profile!!

I had a pt eval a year back I believe, I will have to look back at those documents. I haven't had a single other test done other than an MRI after my surgery.

Is there a difference between a laminectomy and a disectomy? I have seen it in many different terms in my reports.

I am striving to keep my chin up, and it really does help hearing and sharing other people's stories and having other people that know what you have experienced and are experiencing!!

~Commit Random Acts Of Kindness~

Rhonda

[Ginny]

Dear Rhonda,

Wow! I bet your kids are amazing. The nine year old helping his big brother, that's a good heart. Your oldest recognizing that fact shows that he's got a good heart too. Many kids nowadays are all about themselves.

Has your oldest recovered now? Did he have any problems with the screws or rods? With you getting MRSA, did he get it too? You should check out that other section about staph infections.

As for the back brace...I went to the medical supply/pharmacy that my husband gets his from. The lady put me in a large size. It was sooo uncomfortable, but did keep me from bending. When I bumped into the doc at the hospital, she looked at it & said it was too big. She sent me to her pharmacy to get the same kind her mom wears. That fit much better & helped. The physical therapist looked at it & confirmed that I was short waisted (I'd always thought I was long waisted) & that the other chick put me in the wrong size. That pharmacy did help John, though, with a custom back brace that looks like a corset.

I've got the sciatica now going down my right leg. Guess when the flare up is done, I need to do more yoga. I can feel myself getting tight and my flexibility decreasing. I haven't mentioned it at work, frankly, I fear they'll try to find a reason to fire me if I mention it AGAIN. I haven't really noticed pushing on one spot when I wasn't feeling the sciatica to see if it flared up. I remember the doc pushed in 3 spots, I guess they were the trigger spots. She did mention that it could take awhile for the flare up to go away and it did but its back. I can move my leg in different positions and feel a difference. I do wonder sometimes if the xrays were wrong and I really have a bulging disk.

John takes ALOT of meds. He and I both hate that. Mobic is one of the last choices to try because of the side effects. I chewed him out when he came home that first day with the perscription bottle and handed ME the side effects sheet to read. Been nice if he could have read it, but he was too depressed, just wanted to take the stuff. Two of the side effects are cardiac arrest and performation of the bowel. I told him that I don't consider cardiac arrest a "side effect" and I did not want him to risk a hole in his gut and having to have an ostomy (that's where a surgeon trys to save your life by making an opening on your belly for the poop to come out). He was hurting & desparate and took it anyway. Now he swears by it, but he does take Zantac to decrease the stomach acid to decrease the risk for "busted gut".

His frozen feeling is more of a stiffness I think. He doesn't talk about it much, just takes the Mobic and the other meds. His back does get less stiff when the weather is warm though.

As for the difference between a discectomy and a laminectomy. John confirmed it for me...a discectomy is where you take the disc out (or some of the disc), the discs in the back are basically shock absorbers cushions and the laminectomy is where they remove some of the lamina or the bone. If I understand it correctly, its from the facet joints. So ones bone & ones disc.

All the best,
-ginny