I Need a PM Today

[Kathi49]

I wish I could get this stuff figured out! I had the facet Rhizotomy done about 3 weeks ago on the L4, L5 and S1. I was doing great! Now, I am in a flare for whatever the reason. In conjuction with this pain is a weak pelvic floor. I haven't gone into PT for the pelvic floor as I was waiting and taking the recommendation of my Urogynecologist to wait until after this was done. But, boy, I feel like my lower half is being torn apart. I guess what I am asking is...what enervates what? Sometimes it feel as if it strictly arthritic facets and at other times this feels like a piriformis muscle. I guess I have multiple issues going on. And the only thing that seems to help, WITHOUT upping meds, is to put heat back there. Supposedly, rectoceles and cystocles are not supposed to cause pain but rather pressure but I wonder about that. Sorry, I just had to vent. I am supposed to see my PM tomorrow but if it snows like it is supposed to, I will just have to reschedule.

[BrokenBladder]

Oh Kathy the pelvic floor thing is really tough!!! I went to a PT and found out that having pelvic floor dysfunction can cause so many things to go crazy and honestly the PT never helped me at all, but hopefully you will be different.
The PT showed me a very nice book which outlined the pelvic floor muscles and they connect to so much, or should I say affect so much. I also have Fibro, but if one flares it has a real impact on the other.
It took me a while to get the DX for the pelvic floor because I kept complaining about pains there and everywhere. I completely understand how you feel. Big (((hugs))) Also if there is anyway you can make it tomorrow....GO. The pelvic floor muscles need more attention than heat right now. I tried that and it will work for a short time and then it stop working for a while altogether. Good luck and let us know what happens!!

[slipnslide]

Kathi,

Don't make me post that GIANT picture again!....LOL.....j/k:D I agree with brokenbladder & say to do your best at getting to tomorrow's appt so that maybe you can get some answers from your PM. In the meantime, up your meds if you have to and keep the heat on it if it helps.

Let me know what the PM says tomorrow!:) I'd like to know what he says about you having had relief right from the get-go and then it having worn off after a few weeks.

Best wishes,

Kim

[Kathi49]

Lisa,

I know it! It IS painful! So, let's add it all up. Grade 1 Cystocele and Rectocele; not warranting surgery but pelvic floor PT. My Urogynecologist wanted me to get the nerves calmed down first in the lumbar/sacral area FIRST. So, my PM agreed and after facet injections and a subsequent Rhizotomy I was just waiting until the 4-6 week mark passed before going into pelvic floor PT. My Uro DID say that if the PT caused more pain, to stop immediately and he would do the repair(s). My mother just had this done about two weeks ago and she says the difference is unbelievable. :) However, I know I was not graded out as she was; hers was much worse. This is awful to have to contend with because all I want to do is sit down or lie down and that's not good either. So, I try to move around as much as I can. Last night I was desperate so I just soaked in the tub, put heat back there and eventually took a Tylenol which helped a great deal. I am trying NOT to "up" the Norco. Actually, I have been taking just one tablet a day for months. I want to come off of it totally before I try the Lyrica. I also need to contact the Uro again because I will need a new order or script for the PT. And that shouldn't be a problem because the gal he uses for this is in the same building and he DID know I was having the Rhizo done. Right now even thinking about driving for 45 minutes makes me cringe. Lisa, what eventually did work for you?

Kim,

LOL! Please don't post that picture again LOL! I still have it for reference. :)
If it doesn't snow the 6-12 inches they are speaking of, and depending on when it hits, will determine if I go see him or not. I guess it will just depend on when it starts in.

[BrokenBladder]

Kathi that is the million dollar question!! I haven't found anything that has worked long term for me. I was diagnosed in 2002 and have suffered pretty much since 1999. I really didn't want to tell you that because it's very disheartning when you have something that can't be fixed. I hope for you they can find something that will give you long term relief!!
My PT was very honest with me and told me up front that the chances of her helping me were slim to none. I tried it anyway out of desperation, but alas she was right it only aggravated a bad situation. Obviously I'm on pain medication, but I'm on it for several health issues not just the pelvic floor problem. The biggest help to me, other than occasional heat, is a muscle relaxer. I hope you get to the PM tomorrow!!

[Mark N]

Kathi, you are like the boy in Holland trying to plug the leaks in the dike. If there I only one or two holes it is easy to deal with but with us there are many things to juggle and deal with. I hope the appt. tomorrow helps out and you have a good week. I was reminded today, while watching a movie, about the old saying that pain s good because it lets us know we are still alive. Boy is that a different level of pain than we deal with. Ihope you can get your pain under control the next couple of days.

[Kathi49]

Lisa,

It's too bad the PT didn't work for you. I am not sure if you are referring to the internal PT, but that is what they want to try. :eek: And based on what you are telling me I think the Uro was saying the same thing; if it hurts, stop, and he will do the repair(s). What he really said first was that if I were to have pelvic floor PT BEFORE dealing with nerve issues, that the pelvic floor PT would send me over the top. I have heard it can be very painful. But, I will give it a go and see what happens. I just can't go right yet.

Mark,

Exactly! What a fitting description LOL! Now, and this is kind of funny. My husband walked by a minute ago and just patted me on the backside. And I stopped and said, "Do that again, I think you found that painful spot!" So, he pressed on what I think is the Piriformis or the glutes or whatever, and I about hit the roof! It is not my spine but just to left of the sacrum. He thought it was my pelvic bone or something. But anyway, maybe that is why PM thought, too, awhile back that it might be piriformis and not my spine based on the fact that it does not hurt to walk or stand...just sitting and the worse being driving. Geez, I need to see my PM tomorrow. I will try to go if the snow isn't coming down hard. And if pain let's us know we are alive then I ought to be rockin and rollin! :)

[BrokenBladder]

They talked about trying the internal PT but after the horrible pain from the external they actually decided it wouldn't be worth it to me. I'm glad because I think I would've taken someone's head off!! IMHO PT dosen't work but I always say that things are different for everyone!! Hopefully things work out for sure, I sure hope so!!

[Kathi49]

Lisa,

Speaking of PT in general. My PM wanted me to try lumbar and pelvic floor PT with a specialist they use. She is really good! BUT after about 4 sessions I was in SEVERE pain. So, she had me to stop, said something was wrong and that I shouldn't be in that much pain and to go to the ob/gyn. I did that and my ob/gyn is the one who diagnosed the cystocle and rectocle. Then she referred me to the Urogynecologist (mainly because her specialties are infertility and menopause). Well, I should say she used to do it all, but through the years and because her practice grew tremendously, plus she is about ready to retire, she has limited it to those two specialties. Anyway, the Uro ran extensive testing. I don't have incontinence; the problem is more back pain, butt pain and that darn rectocele. He is the one that also told me by doing lumbar AND pelvic floor exercises, I actually made things worse. It must be true as I had no pain until I went through PT. I THINK what he meant is that when I working on the floor exercises and pulling my gut in and to the floor; things of that nature, I was actually pushing down and out. Not a good thing!

Anyway, he did the barium test(s) to see how well I was empyting. Not to be gross and I will try to be delicate. Even though I was drinking water immediately afterwards by the tons and taking the laxatives, the barium evidently got caught in that rectocele and turned to concrete. I did not know this I just knew something had gone terribly wrong and my husband had to take me to the ER. You can imagine what went on in the ER! And Mark can vouch for that one having gone through it himself! :eek: Anyway, my ob/gyn was in shock and was surprised they didn't do surgery. The Uro doc explained that no matter what I done correctly the water and the laxatives had BYPASSED that "thing"!

So, this is why I say I am terrifed of these constipating meds or rather "upping" them. Yes, I know, as long as I take stool softeners, fiber or laxatives this would probably not happen again. But I keep things moving since that episode!

Okay, sorry I didn't mean to be gross. :eek: I will give this pelvic floor PT a try as soon as I can. But for now it is back to the PM today if I can get there. Now they are saying the snow won't be coming until later. So, hopefully, it will be alright.

[Mark N]

Kathi, I have learned [from the Marines and spinal journey] nothing is gross any more. I know it isn't that way for everyone. I saw where the weather channel said snow on Tue and I thought great Kathi can see the PM.

If your lumbar is causing the pain it makes a difference which way the herniation is putting pressure on the spinal cord. For example, flattening your spine to the floor my actually intensify the pressure whereas exercises that have you increase the curve to your lower back could decrease your pain. You need to see a PT that knows the intricate info about lumbar problems.

Good luck at the Pm today.

[Kathi49]

Mark LOL,

The gal they recommended for the lumbar is an EXPERT when it came to lumbar problems and exercises. Oh, and I do have a bulge at L4 but no stenosis. The facets are my biggest problem. That's why the PM and the Uro guy both said to get those nerves calmed down first. But I know what you are saying. However, the Uro guy is saying now...pelvic floor PT only...nothing else for now. :)

[Kathi49]

Oh, yay, I managed to get to the PM today before the big snow storm hits.

Anyway, and this is really confusing to me. But first, it was PACKED at the place today. So, I really didn't want to take up too much of his time. I asked him about the Rhizotomy and then SHOWED him where I hurt. He seemed puzzled for a moment and then pressed hard just to the left of the sacrum. OUCH! But it was a little lower than the S1...I think. So, he sort of explained that there are ligaments and such and asked if I had fallen or anything. So, I told him, "No, I am just lazy and have been sitting alot and doing much of nothing because it is soooooo cold out!" :)

So, he said he could either give me a Medrol Dosepak or he could palpitate the area and go down in there with a look-see and give me an injection. I said NO to the Dosepak because the last time it ripped my guts out. So, and of course, I couldn't see what he was doing, he pressed on that area again and I about hit the roof! I know this sounds stupid, but I am not sure exactly where that needle went. And this one was a painful one this time around. Maybe he went into the joint, I don't know for sure. I just know when he was done I felt so much better and so did my darn ankle...again. Then he told me I would need to stretch more. No kidding! LOL It's my fault for not being more active but I was protecting my neck and shoulder there for awhile. The shoulder is better because he checked that as well and it didn't hurt.

Anyway, I also asked about the Methyl B12 and I won't go there unless someone wants to PM me LOL! Actually, he explained, when I showed him EXACTLY where my ankles hurt, that it is radiculopathy.

And last but not least, the drive home was pleasant. Now, I need to get off of this thing, wait for numbing stuff to wear off and put some ice back there.
Or maybe wait until it snows and sit my butt down in it! :)

[slipnslide]

Kathi,

I'm glad you got relief from today's injection!:D I'm assuming that since he gave you an injection in a slightly different spot, that the pain you were experiencing was not the pain that the rhizotomy was to obliterate....correct? By any chance, could it have been a trigger point injection? I have no clue about these types of injections, by a friend of mine does have trigger point injections from time to time and she says that they are quite painful.

I hope you feel better,

Kim

[Mark N]

Kathi, it is good to hear you in such good humor after what he did to you today. Just remember when you stick your butt in the snow it is 15 min in and 30 min out. I wouldn't want you to get frostbite:D . That would be a good one getting to hear you explain that to your doctor [frostbite that is].

[BrokenBladder]

Kathi I'm glad to hear you made it to the PM and will good results!! You go girl!!
I agree with Mark watch out for Mr. Frostbite, that might be a little hard to explain, LOL!!

[Kathi49]

Kim,

I don't think it was a trigger point injection at all. I have had those in my SCALP before. Talk about pain and crunching sounds! YUCK! And those were a matter of using a shorter, smaller needle and no fluoroscopy. It was an occipital thing back then. No, this was much deeper and I swear into the Sacroilliac joint or something. I wish I had looked at the fluoroscopy machine but I NEVER do as it would make me sick LOL! I know it sounds stupid, but yes, it was about 2 maybe 3 inches lower than where he had placed the needle for the Rhizo. All I can really say is that I was sweating bad because it was pretty painful but I was severely inflamed I suppose. Oh, and slightly off topic. There was a young soldier that had an injection after me. He came out looked at me and said, "Whoa!" Then he explained that the first injection he had done was not a problem and he was relaxed. So, when he came in yesterday he said he was REAL relaxed but about hit the roof after this one. Poor guy, I felt sorry for him as he was so young.

Mark and BB,

Thanks! No, I don't think I will even go outside today. It is BAD! They are comparing it to the blizzard of '78 and this morning talking of up to 15 inches of snow with ice! And, well, I remember the blizzard of '78 and this whole city shut down for 2 weeks! And I remember my brothers went out with a truck with a snowblade and hit the interstates helping people out. Anyway, they are saying DO NOT GO OUT. :eek: