Posted 9/4/2012 7:22 AM (GMT 0)
Hi Kei
I don't think there is any reason to feel stupid for hurting yourself as you did. Accidents happen after all. I broke my leg badly after slipping on a tiny drop of water I had spilled on the kitchen floor!!! My feeling would be, if your shoulder does not improve, to see a physiotherapist. They should be able to do an assessment and advise you whether you have a minor injury or if you should see your doctor. I do hope it starts to feel better soon.
As far as spinal fusion goes, well you will get tons of conflicting opinions. For some, like me, it works. For others, it doesn't. In my case, I was spending a few days of most weeks in bed, my back would lock and I was literally bent double. Pain was awful. After trying everything, injections, pain meds, physiotherapy etc I was at the end of my tether so fusion was the only option left. I noticed the difference almost immediately. Fusion is not to be taken lightly, the recovery period is lengthy, I had six weeks of strictly no sitting. I could lie or stand but sitting was forbidden, other than very short periods to shower and toilet. This was followed by six weeks of slowly building up normal activities.
The problem for me has been that the fusion has directly led to other problems. I didn't know that fusion can lead to problems with the discs above and below the fusion site, and also the sacroiliac joints (I am talking lumbar fusion here). I ended up having to have both my SI joints fused due to pain and have just had an MRI scan to ascertain whether new spinal pain is due to another disc issue.
Fusion should always be the last resort. I would (and did) try everything first and only when every other option has been exhausted, begin to consider fusion surgery. I have DDD, and my herniated disc was dried up and almost non existent so I guess I had reached the end of the line, I had also developed scoliosis. Have you tried physiotherapy, facet joint injections etc. I am in the Uk and the norm here is to try facet joint injections, if they are successful (usually there are three done over a few weeks to make sure) then the next step would be a procedure called radio frequency ablation, basically a procedure done to burn the nerves to prevent pain signals being sent to the brain. This can work for several months and can be repeated. The Idet procedure you mention is new to me, but from what I gather it seems to be similar to the RFA, in that the disc is heated up, obviously that is a basic description. I am not in the medical field as you will have gathered from my very simplified descriptions!!!
The discogram is very helpful. This was the final test I had prior to fusion. Again my simplified version. This was done under sedation, basically you are sedated enough to remember nothing of the procedure, but still be able to communicate with the doctor. After you are sedated a needle is inserted into the disc and injected with water. The aim is to put the disc under pressure to see if the pressure causes pain. This is seemingly a fairly definitive test to check whether or not the pain is coming from the disc. Obviously a positive test would indicate disc problems, and the possible need for spinal fusion.
As for pain meds, well that is very individual. What works for some can be no use to others. On here we are all on different pain regimens and we all react differently and have our own preferences. I have knee problems as well as my back issues and have been on pain meds for many years. I have tried many but I have had most relief from fentanyl (durogesic) patches with sevredol for breakthrough. Having said that I am in the process of slowly changing to OxyContin. I felt as though I had got too used to the patches and sometimes a change is good. Having said that I am not getting the relief I had hoped for from the OxyContin. I also take bacloen, for spasms and lyrica for nerve pain as well as lidocaine patches, also for nerve pain but in a patch form.
If you search fentanyl on this forum you will see differing opinions. Some people just dislike it, some have difficulty with it staying on. That is why I say pain relief is between you and your pain management doctor. You have to try different drugs and work with him at finding what suits you. As well as medications you might consider physiotherapy, hydrotherapy, massage, chiropractor etc. Drugs alone are not answer. The problem with drug therapy is that it often comes with side effects, sometimes severe. The groggy feeling you describe is common to many of the opiod type pain meds. I also have issues with tiredness and forgetfulness.
I hope some of this rather lengthy (sorry!!) post will be useful. Please remember I am not a medical professional, this is purely my own story and opinion. You are welcome to ask me any questions. There is a wealth of knowledge and experience on here. It sounds like you have a lot coming up - will you have to have the cyst removed even if spinal surgery is not indicated? Let us know how your discogram goes and what your surgeons advice is. Living in chronic pain, in particularly back pain, is hard and changes life as we knew it. It is important to try to address the issues in the long term, although surgery can be the last thing we want or need, sometimes it is the best option. However for some it is not the right decision. That is why it has to be your decision, one that you are 100% happy with.
Good luck and take care
Jane