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Family Physician
Family Physician, Doctor
Category: Medical
Satisfied Customers: 2592
Experience:  Emergency Medicine and Family Practice for over 26 years
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I have been in severe pain. My pain level is at a 10. I have

Customer Question

I have been in severe pain. My pain level is at a 10. I have had physiotherapy, epiderals, facet blocks, and just had a discography that i actually fell asleep in. Following the discogram i was sent for a cat scan. I have burning, sharp pain along my spine and it hurts to take deep breaths and feels like knives are cutting through me. I have numbness and shooting pain running down my left leg into my feet. This pain has compromised my life to 0 quality. I can not sit or stand for longer than 10 minutes. Laying in a fetal position is the only modality that gives me little pain relief. My pain management doctor has me on quite a bit of pain medicine that gets me through. I am writing what my discogram says first, then my cat scan. Can you tell me if surgery will give me a better quality of life?
Discogram 5/27/15
Patient was placed in prone position. Lower lumbar area was prepped and draped stairely. C arm was then angeled in right oblique projection and lidocaine 1% 5ml was used on the left side about 6 cm of midline at level of L 3 - L 4, level 4 - l5, level 5 - S1. The patient also has a transitional vertebra no discography was performed at transitional vertebrae because of technical difficulties. Double-needle technique was used and introducer was first passed and contact was made with superior articular processes at each of these levels. 22 gauge needle was then taken and it was passed through the introducer. Again, contact was made with superior articular process. Needle was then walked lateral to the superior articular process and to the disc. Both AP and lateral projections demonstrated needle to be in the midline of the disc. The patient was then injected with Omnipaque 300. Each mL of omnipaque had 10 milligram of keflex. At l3 l4 level, resistance to injection was appreciated at 0.5 ml. Total amount injected with 1 ml. Pattern of dye was cotton ball. This was normal disc. The patient reported no pain. At level 4 - level 5, resistance to injection was appreciated at 0. 5 a.m. Total amount injected was 1 ml. Pattern of dye was hamburger. This was normal disc. The patient reported very minimal concordant pain. At l5 - s1, there was no resistance upon injection. Total amount injected with 2.5 ml. This was degenerative disc with posterior fissur and clefts. The patient report moderate Concordat low back pain.. Needles were then removed. The patient tolerated the procedure well without any incidents and was taken to postanesthesia care unit in stable condition. The patient was given prescription for keflex 500 milligram 1 p.o. q 6 hrs.. Norco 10-325 one to two tablets p.o. q 8 hours PRN for pain, dispense a hundred fifty limit 150; limit 5 per day. MS Contin 100 milligram 1 p.o. q. 12 hours, dispebse 60. The patient was sent for post discogram CAT scan. IMPRESSION the patients Concordant low back pain is coming from L5-S1 level.
My question is: there was technical difficulty at the transitiinal vertebrae. Which disc is the transitional vertebrae? Doctor states he hit all levels, but states there was technical difficulty. My CAT scan shows something different. I fell asleep during discogram. Where is all this pain coming from? My pain is 5x worse after discogram. Here, below is my CAT scan:
I have tried every modality over the 5 years of excrutiating pain: would I be a candidate for spinal surgery/spinal fusion, ect.
CAT scan (with contrast)
Disc levels:
Level 1 - level 2 mild disc bulge without significant central canal stenosis or neural foraminal narrowing. Level to level 3 disc bulge without significant central canal stenosis. Discograham grade 0, normal just without leakage of contrast material from the nucleus. Mild bilateral neural foraminal narrowing. Level 3 - level 4 disc bulge with a left foraminal broad - based disc protrusion without significant central canal stenosis. Grade 4 annular tear, contrast material extends to the outer third of the annulus and spreads cocentrically around the left posterolateral disc. Mild right and moderate left neural foraminal narrowing with mass effect on the left existing l3 nerve root. L 4 - L five broad - base right central disc protrusion causing mild central canal stenosis and mild bilateral neural foraminal narrowing. Grade 3 annular tear with contrast leaking through to the outer third of the annulus. L5-S1 No significant disc abnormalities. Moderate facet arthrosis without significant central canal stenosis. Mild bilateral neural foraminal narrowing.
1. Grade 4 annular tear at the l3 - L4 levels with a left foraminal broad-based disc protrusion. Mild right and moderate left neural foraminal narrowing with mass effect on the Left existing L3 nerve root. 2. Grade 3 annular tear at the l4-l5 level with a broad-based right central disc protrusion causing mild central canal stenosis and mild bilateral neural foraminal narrowing.
Last question: am i a candidate for a fusion or spinal surgery? Thank you!!!
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Phil, MD replied 2 years ago.
Hello. I'm Dr. Phil, licensed and practicing Internal Medicine Physician. Excellent service is my goal.
Can you tell me all the meds you've tried?
Customer: replied 2 years ago.
Within the 5 years, i have been on every narcotic from norco, morphine, Cymbalta, nuerontin, oxycontin, all muscle relaxers, the list is to large to write. Tried Over 31 meds, including suboxone/bupernorphine. Right now i am on 5 norcos 10/325 every 4 hours, oxymorphone, 2x per day every 12 hours. Xanex 0.5 2x per day, cymbalta 60 mg, 1 per day. I have been diagnosed with about 5 disabilities including the spinal problem. I was a candidate for the drug pump and passed all credentials, then the second trial, my body rejected the drug and didn't go back for the third trial because you have to be mentally prepared for this life changing modality, and mentally, im not there, i cant walk for more than 10 minutes.
Customer: replied 2 years ago.
My account was charged $29. Are you still there dr. Phil?
Customer: replied 2 years ago.
I have tried every narcotic from pain doctors within the 5 years. The meds of course are not going to heal me.the oain meds do help, but the quality of my life is 0
Customer: replied 2 years ago.
Dr. Phil if you are there, my account was charged $29 and i am on social security disability and don't make a lot through social security, so for me to accept this $29 offer, i how you are still here trying to get me the answers i need. I am in the process of working with a surgeon, but his secretary won't help me get my medical documents to the surgeon and she will not call my pain doctor who did the procedures to get the results. I cant drive a car because if the pain so i would like to know what other doctors think about my situation.
Customer: replied 2 years ago.
The secretary has the cds and results, but shes missing 1 office notes for june, and states that i have to get her the documents, not her, or my doctor. She won't sign a medical release form faxed to her to the surgeon she works under. So i have to find the strength to get in a car and have someone drive me 45 minutes to get 1 piece of paper and take it to the surgeons secretary. Please dr. Phil, i accepted no limit questions for $29. My bank account was charged. Can you answer my questions about my CAT scan results?
Customer: replied 2 years ago.
Im requesting a refund now.