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I need help w/ MRI results, scared and depressed

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Posted 1/27/2009 7:19 AM (GMT 0)

I am 26 years old and the very proud mother of an amazing 7 yr old daughter! She is my life, and her shining spirit is what keeps me motivated.  But I fear that I'm becoming depressed as a result of chronic pain.  4 yrs ago I was diagnosed with degenerative disc disease and had a spinal fusion (L4-S1). The very serious symptoms were decreased after surgery, but the chronic pain has never left me.  about 9 months, the pain spread to other parts of my back, legs, arms and hands.  In the last 2 months these symptoms have become increasingly painful and have definately began to interfere with my daily life.  I agreed to an MRI last week, and the results are unclear to me because I'm not clear on much of the terminology. My doctor (who i've onle seen a few times) immiediately referred me to a neurosurgeon.  This appt will be in 2 weeks.  If anyone can help me understand this darn MRI, i would greatly appreciate the interpretation.  The previous back surgery was an extremely miserable and painful experience, and very long recovery.  The thought of further operations scares the hell out of me. Feeling very anxious, and unprepared for a visit to the specialist, I'm sinking into a serious depression. This combined with my pain is affecting my daughter, she won't say it is, but of course I can read the child like a book.  If there is anyone who has been in similiar situations who may be able to offer any adivice, insight or suggestions, I would greatly appreciate your words. 

Posted 1/27/2009 8:08 AM (GMT 0)
Kytkat; I want to welcome you to the HW forum. I wish that you were not drawn here by your pain but alike to you all of us share one thing in common....we are all in extreme pain and struggle with day to day activities as our lives slip away from us or as we try to make sense of what our doctors are telling us. I am 45 years old (had a birthday 5 days ago) and know what you are going through as I too have had S1-L4 fused. L3 and L4 was fused as well so you could say I had a triple whammy doled out to me at the age of 37 years old. Nine years of struggling with pain and much stress of going thorough doctor after doctor and test after test as well as injections, mylograms, painful nerve burns, facet injections and other things that have failed to control my pain I am now on several strong medications that do not ease my pain because they figured out that my nerves that are very close to my spinal canal are impinged and all the medications in the world are not going to touch where they are located. However neither is surgery going to aide me. Not one neuro will touch my back again even if any other disc were to rupture, tear or bulge at L2-L1 because of all of the problems that I have had in the past the doctors feel that it would be a failure once again.

I am only one failed story here on HW.....there are many that have or are getting their doctors to look at their cases with some hope of resolve. So I guess what I am saying is even though your feelings of depression are normal and you may feel alone in this and isolated your not. There are thousands like you out there that feel like you and just keep reaching out for answers. Talk to your doctor ask those important questions; What does that mean? What can we do to make this pain go away? Are there other alternatives besides surgery that we can try? Keep asking until you are satisfied you feel comfortable with what he is saying....then.......if he does say surgery.......get a second opinion. Surgery is a big step when it comes to backs and with all the problems you are already suffering I think you are right to be frightened of going under once again. I would make sure that this is your only option before doing that again for sure.

Anyway I do hope this helped and again welcome to our little world.

Scarred

P.S. If you are wondering if there is any end in sight for me and my dilemma....there is. One thing that my doctor wants to actually try is placing the Neuro Stimulator in my back to see if that will decrease some of the pain that is going to my legs and feet. Kicker is Wyoming Worker's Comp doesn't want to pay for such an expensive and what they feel to be a usless treatment.
Posted 1/27/2009 8:17 AM (GMT 0)
Dear Kytkat,
It's late and I'm kinda groggy, but wanted to welcome you to the chronic pain forum, but so sorry you have to be here, especially at such a young age. I had a L4-S1 fusion a little over a year ago, but I'm in my upper 50's.

I think you already know what I'm going to say - which is to make sure you've had a second opinion before getting further surgery. Neurosurgeons are good people and can do a lot, but their first inclination is surgery. My surgery did not help my pain, and my surgeon wanted to do another surgery and I declined. But that does mean ongoing pain meds, and whatever else I can throw at it - anti-depressants, PT, home TENS unit, etc.

What I think might be helpful is for you to try to find a psychologist or counselor who is trained in helping with chronic pain to help both with your depression (which is very common with CP, myself included) and as a support to help you make decisions. Making major decisions while you're depressed isn't the best idea. Also, be sure to rely on any friends or family that are supports for you.

Hope this helps some. The people on this board are also a great support, although we aren't doctors.

Sorry if I'm a bit out of it!

PaLady
Posted 1/27/2009 9:06 AM (GMT 0)

Thanks so much for welcoming me! I've been reading different posts on this site for over two hours now, and I must say that I now know my situation is not being suffered alone.  i really had no idea that there were so many people who could relate.  I thought I was some shameful person because of the way i've been treated by the doctors that i've gone to for help since relocating to WI from KS.  When i told them I had been on methadone for 18 months for chronic back pain, they displayed little compassion, and lacked prefessionalism when they all told me to look elsewhere immiediatley. The first two that I saw refused to treat my pain at all and could offer no suggestions for doctors that may be able to help me.  Finally found a dr that looked at the MRI from 4 years ago showing my fusion and hardware, guess he needed proof! I told him of the new and increasing pain that was becoming intolerable, so he agreed to give me lortab 7.5 and set up a new MRI for me.  After reading the report he told me today that he would give me oxycodone 10mg 4times daily, and that he is turning my care over to a neurosurgeon i have yet to meet.  he didn't take the time to explain the MRI results to me.  But made it perfectly clear that my condition was too serious for him to be treating me.  So i'm left trying to do my own research on what these new findings are...C4-C5disc herniation with moderatw impingement on right aspect of spinal cord ok i do know what this is..next,c5-c6 broad base osteophyte with superimposed disc protrusion,causing significant flattening of the anterior and especially the left aspect of the spinal cord. osteophyte a bone spur? dimension of the spinal canal is reduced to just over 6mm midline. shows moderate deformity. c6-c7 neural forminal stenosis deformity with triangular configuration at the point of maximum narrowing. at t6-t7 moderate right disc protrusion with moderate impingement on the spinal cord evidence of sifnificant cord compression. several moderate Schmorl's node type deformities at the inferior endplate of t7 and at the superioe end plates of t8. what the hell is this?? spinal insrtumentation spanning l4-s1. total laminectomy at L4 and L5 appears well decompressed. the disc at L3-L4 shows severe degeneration with decreased height of the disc and broad based posterior ostephyte combined with bilateral facet hypertrophy causes significant residual central spinal stenosis at this level. the reduction in the central spinal canal area is perhaps 70% at this level. how bad is this?? crowding of the cauda equina at L3-L4. significant posterior osteophyte accompanying severe degenerative changes at the L5-S1 disc. fusion may have been attempted at L5-S1 disc space, there is now significant central spinal stenosis due to bilateral facet hypertrophy and posterior disc herniation at L3-L4. You see i don't understand most of this and i have to wait 2 weeks to see neurosurgeon...my pain has become intolerable too much of the time, I'm scared and have no idea what to expect.  Does anyone know what this MRI is indicating? how serious has this become...please if anyone can interpret any of this please help me to understand. 

Posted 1/27/2009 9:18 AM (GMT 0)
Sorry that was so lengthy, apparantly i'm quite anxious in not knowing whats going on with me.  My family is supportive. My mother who was an LPN for 30 years is now disabled with multiple sclerosis, she has a good understanding of chronic pain, but i've chosen not to share these MRI findings with her yet.  Her health is fragile, and she depends on me for much of her care.  The idea of having more surgery would keep me from caring for her and our home adequately.  I've become increasingly unable to do much for our home already, i can't imagine how i will be able to take care of our home if trying to recover from surgery.  I'm becoming emotional and overwhelmed with what i might be facing here.  The pain is worse now, but i've dealt with chronic pain for over 7 years, but not knowing how i will care for my mom and my daughter is the scariest, most frustrating aspect of my state if mind.

Posted 1/27/2009 8:06 PM (GMT 0)
kykat; first off it sounds like you are in a lot of pain and wondering what your next step is from here. I would take a deep breath and try to concentrate on other things at the moment as there really is nothing that you can do about the results of your MRI until you see your new doctor and your only causing yourself undo stress. Secondly you have to realize that we are not doctors on this site. We all are CP patients that have come together to help one another through a difficult time in our lives. I could not tell you the first thing of those interpretations of your MRI except that your doctor needs to tell you what it is that you are dealing with. Of course this is only my opinion, you can take it or leave it kat I am just trying to let you know that I think that you are getting yourself worked up over something that you cannot control at this time. Until there is a doctor that tells you that surgery is your only option of recovery from your pain I believe you are only causing yourself much stress and really putting yourself on an emotional roller coaster before you have any information from a surgeon.

I realize that this is a scary time and that emotionally its very trying...believe me I've been there so many times that I think I could write a book at times. LOL But in my opinion there are other things to consider here. Maybe there will be other options.....Tens unit....PT......Injections......you never know. But until you actually have a doctor tell you your options I really feel that you are putting yourself in much undo stress. IMHO I would (now remember this is just me..) take a long look at the big picture.....then...take a hot bath......breath deep and relax. Go get my mind off of the situation at hand and remember that until there is an actual plan of attack of what your doctor plans to do to care for you...your pushing buttons that are disconnected (if you understand my meaning).

Just my opinion. Have a lessen pain day and welcome to the Boards.

Scarred
Posted 1/27/2009 8:15 PM (GMT 0)
Kytkat,
We're not doctors and can't interpret the MRI for you, but stenosis is narrowing of the spinal canal. Any anywhere there's compression on a nerve that can mean pain. It seems like you have significant changes going on in several areas of your spine, so probably the neurosurgical consult is going to be the best thing, but again I'd encourage you to get a second opinion - especially from a very experienced neurosurgeon. I would start listing your questions now, including what all the MRI results mean, and what various surgical procedures can and can't do for you. I know from reading for myself that disks that are adjacent to where a fusion has been done can start to herniate, and I think this is happening a bit to me. I think of my spine as a ladder (this is purely my own way of looking at it, not anything a doctor told me) and that now the bottom couple of rungs are fused together, but some of the upper rungs aren't so straight and solid anymore either. And since in our bodies there are nerves running through the openings in the ladder, wherever the nerves don't pass freely means they have some pressure on them and that means pain or other sensaitons (or maybe loss of sensation, or even motor functioning) in the area of the body that nerve goes to.

It's a lot to digest, I know, and that's why I think a psychologist or therapist with a background in chronic pain could help you with this, because they're also going to be able to help you interpret your doctor's findings. So if you don't know one, you can ask you doctor for a referral, but be sure it's someone who deals with chronic pain. Neuropsychologists are also helpful; they kind of have specialties in psychology and neurology, but it depends on who's available in the region you live.

Hope this helps some. And you can find a lot of good info. searching other threads here, and asking others for support.

Keep posting!

PaLady
Posted 1/28/2009 4:58 AM (GMT 0)
Hi Kytkat,

I also wanted to take a moment to welcome you to the chronic pain board of HW. It is unfortunate that you have to be here because of pain, but we are glad that you have come to join our family. I wish I could help you, but I don't know much about the back, as my pain is in a different area. It does sound like you've gotten some good advice from others already. Waiting to hear your results is always the worst part of any test. As you know, it can be beyond frustrating. Hang in there! In the mean time, this is a really great place to come for support or to vent to people who understand what you are going through. Keep posting!

Skeye
Posted 1/29/2009 4:18 AM (GMT 0)
Hello, I too want to welcome you to Healing Well. Wow, you do have some significant findings going on in the cervical spine. No wonder you are having the upper body problems. I am very glad to see you are going to see a neurosurgeon soon. In my opinion, and its mine only, I would only see a neurosurgeon for either my neck and back, oh, I have been seen by both. But, when it comes to surgery, only a neurosurgeon for me. He is much more qualified in the nerves in the spine than an orthopedic. Kuddos to your doc for admitting he was over his head in trying to take care of you, I highly repect any dr that will admit to that.

 

The Schmorls node don't worry about it. I have it as well and for some reason those things only get in the thoracic spine. My neuro says that is something that they do nothing with. I believe he said it was congenital.

 

You know what the narrowing is, it can cause pinched nerves which can cause a great deal of pain.You can experience pain going down an arm and have numbness in certain fingers on your hands, shoulder pain too. You have 3 levels in your neck that all show problems going on, that will cause you alot of pain. I am sure by now you have looked up alot of this online. Lots of narrowing/stenosis, osteophytes, degenerative changes, yes your neck should hurt. 

 

As for the lumbar spine you have a couple of levels that your facet joints are involved, they can cause hell from pain too. Surgery is sort of last result from what I have read on the facet joints. I have big problems at L5-S1 which is the very bottom disc. From the way your report reads your fusion may not have taken at L5-S1, I say that because it says that it looks like a fusion was attempted. Your back reads pretty much the same as your neck, degenerative changes, stenosis, osteophytes(Bone Spurs), loss of height space at one level. Certainly enough problems to cause pain that you are describing.

 

I am not a doctor. I have read, oh gosh, I don't know how many thousands of MRI reports over a 20 some year plus history of working for attys that did personal injury, worker's comp as their primary practice. So, I do have some understanding in reading a report.

 

Are you another surgical canidate? Who knows, that up to you and a doctor. I don't know if a dr would even consider going in and trying to clean up your back or even if you would benefit from it. The one thing you do need to ask about is if the fusion took at not at L5-S1. Please write that down on your list of questions. As for your neck, that can go either way. It will not surprise me if surgery is offered on your neck. Alot depends too on you and what you are willing to do. One thing is for sure,  you have alot going on in both areas to warrant having the pain you have described thats for sure.  

 

I don't know how long all of this has been going on. But, before having any surgery always get a second opinion. As someone suggested, make a list of questions and take them to this dr appt coming up. Have your MRI report in hand, have this dr explain in detail what he think of the MRI's.

 

Depression and pain go hand in hand. I can assume you have a primary care physician. By all means get an appt and go in and discuss how depressed you are feeling. Get on an antidepressant as quick as you can. Sometimes they can even help with the pain. You may have to try more than one to find the one that helps you, this is not uncommon. All antidepressants are not created equal.

 

If surgery is not an option and conservative care is the plan, then by all means ask for a referral to a pain mgt specialist. Get into a dr that deals with pain and understands pain. But, one thing you need to know, some pain drs will not give pain medication, all they want to do is injections and procedures. Be sure and ask if the dr gives medication as well as injections & procedures. Do not feel awkward asking this question because there are two kinds of pain drs. One thing we have all learned, when it comes to drs we have to advocate for ourselves. The old Marcus Welby, MD days are long gone,lol.

 

I do hope that you decided to hang out with us here. We really are a decent group of people that have one thing in common for sure pain. We may have pity parties, (those are allowed but you have to invite everyone), vent, need a shoulder to lean on, lot of tips, alot of compassion and understanding. Not everyone understands chronic pain.

You have alot on your plate. Like the others say, don't keep stressing yourself out over this. Stress will just make you hurt more because your muscles will just tie up in knots. Take nice long warm soaks in the tub, invest in a moist heating pad, anything to help you relax. Just cross each bridge as you get to them don't try to cross them all at once. Please keep us posted on how you are coming along..Susie

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