Husbands MRI of Lumbar Spine

[Cats Meow]

MRI Report:

Findings: Vertebral body alignment is normal. Loss of disk height and signal at L5-S1 compatible with degenerative disk disease.

The conus medullar is is at T12-L1

L1-2 Is within normal limits.

L2-3 Is within normal limits.

L3-4 with mild degenerative facet disease. No central stenosis.

L4-5 with mild degenerative facet disease. No central stenosis. AP dimension measures 15mm

L5-S1 with a focal small annular tear and small central subligamentous HNP. However, no central stenosis. AP dimension measures 13mm. Diffuse facet slerosis.

Impression:
1.) Small annular tear and subligmentous HNP, L5-S1 without central stenosis or lateral recess stenosis.
2.) Diffuse degenerative facet disease L3-4,L4-5 and L5-S1.

I don't have the images but I may ask to get the films. I'm not sure if I have to pay to have a copy of those or not but I would like to have them since people read MRI's differently then others from what I gather.

Ok…. So can anyone help explain this to me in layman’s terms? I understand most but what is his most likely future outcome? Keep in mind He is 31 years old and a healthy weight for a male.

Oh… And as far as his new medication (Opana LA 20mg 2x daily) he called me today (he stayed home) and he said he felt weird today (he took it on an empty stomach like it said) about an hour and ½ after he took it he did throw up several times (he said the pill did not come up.. Must have already dissolved) He said he had a hard time keeping his balance and felt really strange (I guess euphoric). He said no medication has ever made him feel that way before and he hopes it dissipates soon but he said for the first time his pain was almost below a 5 and he only took 1 break through about 8 hours later. He had very little activity today so the real test will be when he is able to go back to work how his pain levels will be.

So anyhow…. Anyone care to give me feed back on his MRI on their thoughts? He goes for his cervical MRI tomorrow morning and I’ll report those when I get them.

[Mark N]

He clearly has a problem at L5-S1 and the other areas are consider minor degeneration changes as we age. The true measure, as I and my OSS see it, is his symptoms tell the real story about how bad it is. People with the same MRIs can range from no pain or symptoms to unbearable pain so it is the symptoms that are most important. I hope he adjust to the Opana since it gives him better pain relief and he doesn't need as much BT meds.

[Kathi49]

Agree with Mark. But just wanted to add that I have facet degeneration and it can hurt bad! My MRI reports always say mild to moderate facet degeneration. But when that darn medial branch nerve is affected; the facets hurt pretty bad...then time for facet injections. The good thing is...they can do an RF on those. I had an RF done in the lumbar and it gave me great relief for a year. I am not sure about an annular tear so maybe someone else can provide more information about that. I also hope he adjusts to Opana. And as far as the films go, I usually am given mine to hand carry to the doc. But I have asked for a CD before for my own purposes and the first copy is free. Any additional copies cost....CD's that is. You might want to check with the imaging center and see what their policies are.

[ErinENj]

Like Mark said, while the MRI results seem to say that the biggest issue is at L5/S1, with some minor degeneration in the facets (I'm not sure about the facets. My issues are at L4/5 and L5/S1 so I know a little bit about MRI reports and what the medical greek means. But his symptoms are the biggest part of the story. I think that while diagnostic tests like MRIs may be helpful, symptoms tell a lot more. I had a doctor who told me that my pain was all in my head because he didn't see anything on the MRI, but I was having horrible pain. He was a quack, and it really reinforced to me how important symptoms are when planning treatment.

With the Opana, I'd definately call the doctor. The dose may be a bit too high. I would strongly urge him not to eat anything with the pills. The instructions are like that because eating with them can cause the meds to kick in stronger than they would otherwise. So with his current reaction to it, I would make sure he sticks to the instructions as much as possible, and while it may seem like eating would diminish its effects, it will only make it much worse and can lead to him having too much in his system at a time. His doctor may want to go down to 10mg at a dose, to see if that would work. I'm not sure if they make 5mg pills , so I don't know if it is possible to go to that level to see if he had a better reaction to it.

I hope that the doctor can fix the dosage to where the Opana works and is able to deal with his pain effectively. I've been on it for more than a year and it has given me the best pain relief that I've had since this all started. It works really well for me with little side effects, but I do remember that when I started it, I struggled with some stomach issues as my body adjusted to it, BUt the vomiting would be a big concern, so I think your best bet is to get in touch with the doctor and see what they want to do.

[Cats Meow]

Mark,

I talked with the radiologist when I took him to get his MRI of his neck and he explained things to me much better. He said you would be amazed by some people that have budging disks but exhibit little to none signs of pain. While others… well just like you stated…. But he said that there is more then likely a lot of inflammation in my husband’s case, which is most likely the cause of most of his pain.

Kathy,

I know he has had those injections before. I honestly can’t remember the exact ones and I’m waiting for his previous records so I can show this new doctor the previous injections and they were preformed undo fluro so I know the old doctor was injecting the right area’s. Unfortunately he received very minimal relief and afterwards he said his stomach would hurt. I’m not sure what would have caused that.

I was able to get the films of his MRI but unfortunately they don’t have them on disk. They said they are working on getting them on to disk eventually but currently it is not available. I’m not sure if I can take the films somewhere and have them scanned in without ruining them.

ErinENj,

I know that is the hardest issue for him to deal with is he has had many people (so far not doctors) but many coworkers tell him he needs to suck it up and be a man and deal with it. You know that has got to be one of the cruelest things you can say to someone without even knowing all the facts of his history and it eats him up inside when he hears his friends going out and dirt bike riding or some other physical activity and knowing what his limitations are. He often tries to push his boundaries and pays for it and it is now getting to the point were he really can’t even attempt to walk that line. Of course his parents worry about him constantly and his dad keeps pushing him to go for that Vax-D or to try that traction thing for his back and that don’t understand why he has to be medicated. I am slowly getting them to understand and I know it’s hard for them to see their son going through these issues but again they don't see him everyday.

As far as the medication he seems to be doing good. I know he said he doesn’t have any of those odd side effects like he did when he first took it. He seems to be getting some relief but it seems it up and down allot. For the first few hours it seems it helps then his pain creeps right back up again and if he does take a BT it not that effective. I keep reminding him that he will most likely be sore for awhile and going up on the dose I seriously doubt will be any more effective and he has to be patient and let his body heal.

I’m hoping of the course over these next few months once he does get a grasp on his pain control then he can go down a little on the dosage and still have the same relief. I think it’s the inflammation that is the root of most of his pain (in his back) but I could be wrong. And every time he has tried Anti-Inflammatory he ended up coughing up blood. He has always had issues with his stomach so any medicine he takes is touch and go and I’m not sure if there is an anti-inflammatory he could take that would not cause irritation to his stomach but I’ll ask the doctor the next week.





I should be getting his MRI results on his neck this week and I’ll post those results as well. With all this paper work I have on his health history it’s starting to turn into a novel! I know when we were in talking with the new doctor and after we went over his past history he had a stunned look on his face. And everyone on here has been helpful to me as well I’m shocked that many of you even reply back after I elaborated on his medical history past and present. :o

[ErinENj]

Inflammation is most definately not helping. An anti-inflammatory isn't going to do anything if the thing that is causing the inflammation is there or being exacerbated by certain activities. Because they can so negatively effect his stomach, a muscle relaxer might help. For me, I know that inflammation is bad but then my muscles knot up around it and make it all that much worse.

But I can completely understand that position. I tried to hold on to the remains of my old life with a vice grip, but slowly it just made things worse, so I had to give it up. People didn't understand, and they never will. My friends try, my family tries, but without being in this body, no one knows. And then to have people pull that crud with the "just deal with it" and "why is this such an issue? You know, I have back pain and I just suck it up." There's nothing more insulting in my opinion. And its cruel, because it does put that seed of doubt in your head. "Well, maybe I am making too much of this. If they can deal with it, why can't I? Is this all in my head? Am I just making it out worse than it seems?" And that becomes one of the worst things standing in the way of getting the treatment we need.

The biggest lesson I've learned is the balance. There's a balance between doing what I love and doing what I have to do. I know that I will have to rest at least a day if I go out on a Friday night. And I know that it'll be a nightmare of pain, but it's worth it to go out with my friends. I call it my 'soul refresher.' So it's worth it, but I know that I can't do it all the time. But it takes time to figure out the balance. It's different for all of us. I know that riding a dirt bike would take a lot longer than a day to get over, but if that's what he needs every so often, then that's what he needs. It's kind of like what my mom used to call a 'mental health day'. It was a day that I could take every month or two, and just stay home from school because the whole experience was causing me too much stress at that point in time. It's something that keeps him sane. But he has to understand that it'll be a sacrifice.

I'm glad that the side effects are calming down substantially. Sometimes, it just takes some time to get it worked into your system and then it calms down. But now the dosage has to be worked out. The dosage schedule could be off (it's every 12 hours?) or he may just need a little bit more to make it that whole time. I know that my daytime dose isn't enough for the entire day, and that the afternoon is a time when I need to take my breakthrough med to give it a boost. I take dilaudid, which works fantastically with the Opana in my case. What breakthrough is he on? Some work better for different people and with different medications.

I definately have more to say, but I am under a serious deadline at work right now and have some things left to be done tonight, and I'd love to see my bed before sunrise. I do have to say though, your husband sounds just like me! :D I was and still am so stubborn about giving things up and I had a really hard time with the whole 'it's in my head' situation. Besides other people, I had a doctor tell me that my pain was all in my head after looking at an MRI that showed practically nothing wrong. He said it with a straight face and actually recommended a shrink that could help me with my "problem". And it got me wondering - was he right? Was it all in my head? It went right with my aunt telling me that she had 'the exact same problem and all I did was go to the chiropractor and I was fine. I didn't need surgery or pain meds, I just dealt with it. I don't understand why you can't just suck it up.' She gave me all this great advice about what she did and what I should have done after my second surgery failed. It probably would have been helpful if she actually showed up to the hospital when I was first admitted for pain, before the surgeries, when I actually could have followed a little of it. Sorry, that one still hurts.

Tell him to keep his chin up. It's his pain, no one else's, so they have no clue what it's like for him. Other people are just that, other people. Tell him to focus on his pain and after thanking people for their great, helpful advice, put it right out the other ear, even with his family. They'll never understand, because just like you said, they don't see it on a day to day basis. And that there's a balance with everything. I can completely understand not wanting to give up those things, but that giving up walking is a lot more of a sacrifice, and doing that kind of damage isn't reversable. And tell him that he has a wonderful wife for posting on this board to try and find some help for him. ;) Please let me know if I can do anything to help, and I'll be back to post more tomorrow night. Oh, and by the way, how old is he?

[Cats Meow]

Erin,

I know he has tried some muscle relaxers before but I think just like most people he just gets tired of shoving pills down his throat. You have one to counteract this and one to help this and one to this and that and he gets so frustrated and confused. He can’t remember the name to most of his medication much less what they are supposed to do. So I now write notes on the bottle to help him remember.

He does his best to balance out but I know there are times were he wants to keep going but his body won’t let him and he has still kept a hold of his toys and still is not willing to depart from them. I know he has said time and time again if I feel like this now (He’s 31) I know I will be hating life when I get older. And being that he is younger it makes it 10 times harder to get proper care or to be taken seriously. Plus many do take a look at him and lump him right into that drug-seeking category.

He now tends to keep more to himself since most people his age don’t deal with the issue’s he deals with day in and day out. So you have those that whom you would consider your friends say harsh judgmental comments and not think twice or even once in my presence we had someone ask how he was doing (been few years) this person knew his accident history and then finally after beating around the bush came straight out “So your Doctor hooks you up on some great stuff… right?” You know I have to be honest I was not a bit surprised by this but I could see it really irked my husband of course he snapped and replied “Ya, I planned this all out I figured by the time I had my first accident (neck fusion) to the time I had my skull split open I was doing it all along just to score from doctors. Never mind the fact I had to learn to walk, talk and feed myself again… but you know the drugs make all that go away” needless to say we have never heard from that person again ;). Yet again people will never cease to amaze me with their ability to completely arrogant and egocentric for a lack of better words. It’s pretty obvious I could ramble on… As I’m sure everyone on here has his or her fair share of stories.

He is dosed on the LA every 12 hours before he was on Morphine Sulfate 30mg (3xday) I know he was happy when this one would only be 2 times. I know he has a rough time getting up and going and by that evening he has exerted so much energy just from what is considered normal daily activities he is so fatigued. And since this accident it takes everything in him just to make it home shower and eat then sleep. I’m sure given time he will heal from this recent accident but I’m sure he won’t be the same as before it happened. And as for his BT he is on Loratab 2xday or as needed for BT. But He’s had that same BT for years so I’m sure the next visit they will be changing that. First thing they changed was the LA give it time and now the next thing to tillerate will most likely be the BT.

He is most defiantly stubborn and while he has not had a doctor yet tell him it’s all in his head (like co workers or realitives have stated) but most feel he is too much of a complicated case. When I was calling around for him I had to start out by telling the person ok bear with me I need to know if your doctor can handle my husbands case and once spill it all out I only had one person that said they would be more then happy to take over his care. I have finally got to the point were I just hand them a list of previous injuries along with x-rays, Cat-Scans, Mri’s and surgery reports. Talk about a daunting task! This is why a HATE switching doctors.

I know it does make him feel better when people on here say they know where he is coming from. It has also helped me better understand him because he is not so elaborate or elegant with his words when he is in pain. But I do know what is like to not be understood and living with a condition, which no one understands, but what I have affects a different part of my body and no cure yet (Lucky me! ;) ). So we’re kind of like one big happy screwed up family :p! I’m still shocked our son came out normal (I think!) :p.

To help sum up his history
1994-Neck Injury (life flighted) Neck Fused C5-C6

1997-Head Injury (Life Flighted) In coma 2 weeks took a year to gain mobility on right side and speech therapy. The doctors tried to get us to cut off life support it’s very obvious doctors aren’t always correct as they said he would never walk, talk much less function again. (I was pregnant with his son when he was in ICU)

2008-Flipped his truck (wearing seatbelt) on highway missing 2 semis and walked away.

No I’m not sure how many lives he has left but he said he’s glad someone is on his side even though he’s not a perfect angle.

Ok I think I have gabbed enough! :eek: