Hi, before I tell you my problems now I'll give you a small history. I
had a discectomy when I was 14 years old on my L5-S1 disc in my lower
back. I had constant pain throughout my leg(dont remember which leg it
was it has been so long) it got to the point where I could barely walk.
Finally went to a back specialist at university of michigan hospital
where he told me the bad news and said the best thing would be to go in
the and take part of the disc out. It worked, a couple monthes after
surgery I wasnt having too much pain anymore and about a year later,
despite sometimes pulling a muscle, my back was pretty much back to
normal.
Well I never did the back exercises to strengthen my back like I should
have and sure enough one day about 6 monthes ago, now 26 years old I
felt a great pain in my back, I couldnt walk and had to lay down. I
thoguht I just pulled a muscle but the next day my left foot was numb
as if it were asleep and my left leg also had little feeling behind the
calf and thigh, I couldnt stretch out my leg muscles and had no power
in the leg. I made an appointment at a different hospital this
time(from a recommendation) and sure enough the L5-S1 disc was
herniated pressing on the left S1 nerve root. This time a
microdiscectomy was performed to remove the herniation. After surgery I
never really improved, my leg felt a little bit stronger but the
numbness in my foot has never gone away.
Then one day about two weeks later as I layed down to go to bed I
started noticing a strong tingling sensation in the foot, as it is
being shocked or electrocuted. It was bothersome and kept me from
sleeping. A few days later I started noticing a little bit of tingling
in my groin area and even a little bit in my testicles. This scared me
so I called the surgeon who put me on a steroid, it didnt work. I got
another MRI of which the surgeon did not look at with me, he simply
sent a report to my family doctor saying everything was good, I dont
think he even looked at it, I left it with a secretary and he said he
would look at it later in the day. Well it has been two monthes since
surgery and the tingling and numbness in my foot is probably the worst
it has been, and also i have tingling sensations around my testicles
probably 10 to 20 times a day. I decided to have the MRI sent to me and
sure enough in my eyes it looks as if the L5-S1 is still sticking out
towards the nerves, not as obvious as before the surgery though. The
MRI report from the radiologist states the following
"1. Postoperative changes with a laminectomy on the left side at L5-S1
level. There is the suggestion of a small recurrent/residual disc
herniation
at L5-S1 level on the left side, which appears to be lateral to the S1
nerve root on the left side with mild compromise on the left S1 nerve
root.
2. Degenerative disc disease with a radial tear at L3-4 and at L4-5
levels with mild disc protrusion at L3-4 and mild broad-based disc
bulge
at L4-5. "
I knew I had the bulges on the other two but they are supossedly not
bad enough to cause any pain.
It also says
"There is evidence of nonenhancing soft tissue in the ventral
aspect of the epidural space on the left side at L5-S1 level which may
represent a focal disc protrusion. The S1 nerve root seems to be mildly
compromised with the presence of contrast enhancement, as well. "
Whats that mean?
I don't know what any of this means so I called the surgeon again and
he told me that my nerve was just irritated and swollen and gave me the
name of a doctor to get steroid shots directly on the nerve to heal it.
Well I'm pretty convinced there is something hitting the nerve that is
causing this tingling I never had before surgery. Im not sure if
something was missed or I had a reherniation but Im fairly positive
something is wrong. I sent a referral letter to my regular doctor today
from University of Michigan and hopefully he sent it back(you need a
referral for a U of M appointment) but that will probably take a week
or two before I can get in there when they get the referral. I'm also
going to see If I can get a steroid shot and see if that does anything.
I was on the verge of going to the U of M emergency room today when
last night I couldnt sleep due to being so uncomfortable with the pins
and needles going throughout my foot and groin/private area. I decided
against because I'm not sure if it is an emergency or not. If anybody
has any clue on whats going on or what I should do any info/help is
appreciated.
Robert A. Fink, M. D. - 25 Oct 2006 23:32 GMT
>Im not sure if
>something was missed or I had a reherniation but Im fairly positive
[quoted text clipped - 9 lines]
>has any clue on whats going on or what I should do any info/help is
>appreciated.
You should definitely go back to the University of Michigan Hospitals
and be evaluated by one of the academic people in the Department of
Neurological Surgery. A person who has had previous disc surgery
represents a more complicated case than a "fresh" case. Good luck.
Best,
Bob
Robert A. Fink, M. D., FACS, PC
Neurological Surgery
2500 Milvia Street Suite 222
Berkeley, California 94704-2636
***********************************
NOTE: The material contained in this
message is not "medical advice".
Medical advice can only be given after
a face-to-face, "hands on" session
between doctor and patient.
***********************************
"Ex Tristitia Virtus"
smallworld - 28 Oct 2006 18:06 GMT
Sounds like you're suffering. Unfortunately, medical-legal concerns
define that no specific treatment or evaluation advice can be given.
That said, here are a few general perspectives.
Unfortunately, surgeons are compensated for doing surgery and
post-operative care is lumped within the surgical payment. Thus, many
surgeons become quickly disinterested after surgery is done. In
addition, surgeons like their results to seem stellar. So, it is not
unusual to hear a surgeon consider a surgery successful (by a very
limited set of criteria) even though the patient doesn't (by a broader
set of criteria). If your surgeon seems uninterested these may
contribute. And, if these are relevant you may not be able to make
him/her become interested.
It does sound like you continue to have nerve irritation and/or
compression, possibly now also involving the S2 nerve root. What was
seen on the scan could represent scar or persistent disc.
An EMG/NCV study could evaluate for objective evidence of nerve
abnormality. If this is found it becomes a useful tool to engender
interest from further evaluators. If it is negative it does not mean
you don't have symptoms, but could provide some reassurance about what
is happening to the nerve. EMG/NCV studies are generally done by
neurologists or physiatrists (rehabilitation MD specialists). Perhaps
I'm biased, but I think the former is better if you are trying to make
a diagnosis and determine a course of corrective action for a "new"
problem. Both neurologists and physiatrists are paid for taking care
of a patient, rather than for simply doing a procedure. So, their
inclination to struggle with you over this problem may be higher.
While your surgeon may not be attentive you can at least get his/her
attention by indicating that you would like further diagnostic
evaluation of the problem by a specialist who is focused on evaluating
such problems. (A GP may be a great person, but he/she isn't focused
on delineating difficult neuopathic problems.) Should your surgeon be
unwilling to support your further pursuit of the problem then you may
have reason for concern.
I hope this helps. I wish you success in finding relief.