I failed to notice some details in your last post. How long did your surgery take all in all? What type of surgery (method) did you have? What did they do? My laminectomy L5/S1 did not take more than 1 hour in all.
"The surgery took 2 hours LONGER THAN EXPECTED" ... This arouses my curiosity!
Post by kilg0retr0ut on Jun 7, 2017 8:05:07 GMT -8
Yes, I've seen the report. To keep it short, I had a boat load of disc debris to remove out of my "massively compressed cauda equina". Then went in for the normal cut, once there they found it was compressed from below, so they opened me up some more. It wasn't a scheduled, just ended up in the ER. The surgeon used some dandy words like " obliterated", later I find I'm not alone with the "worst I've ever seen" , but still... it took awhile. The report said he even used a dental tool? He must of done something right because I've doing better than I ever thought I would. I'm lucky.
Post by ladylimpsalot1 on Jun 8, 2017 15:11:18 GMT -8
Avah, I wonder how you are doing now? Doctors do not like to diagnose Cauda Equina Syndrome, mainly because if CES is diagnosed, it means that they were negligent in not catching it and doing surgery sooner. I wonder myself whether it was CES because you went through a while between your first visit to the ER, and your eventual surgery, and generally if you present with acute CES-the large disc putting pressure on the spinal nerves, causing problems with mobility, defecation, urination, pain and numbness, you lose the ability to walk within a day or so. It took them way too long to do the surgery, and in spite of your horrendous bladder problems, you are still walking, right? And I am not an expert, just someone with questions. I wonder if you might be classified as someone with a more gradual CES. I think it's called slow onset.
To answer a question raised - the surgery I was told I was having was a microdiscectomy at the L4/L5 level. They were going to leave the smaller disc herniation at L5/S1 and treat it conservatively. I have been informed that my surgery took 3.5 hours (I was told it would only take 1 hour). The reasons for this are not yet fully clear but I have requested my full health records, including details of the surgeons report.
My wound became slightly infected and has been stapled in such a way that I will be left with small flap of skin overlapping the wound. The infection appears to be clearing up well.
The pain I was previously experiencing down my left leg has disappeared but can still be felt slightly in my left buttock and I still have a numb patch of skin approx. 20cm by 6cm on my outer left thigh. My lower back is more painful than before and the surrounding muscles go into painful spasm regularly. More worryingly, I have now began to experience sciatic pain down my right leg, through my thigh, calf and around the outer aspect of my ankle and foot (this was not obviously present before my operation). However, I wonder if right-sided sciatica actually was present but due to the level of pain relief I was on prior to the surgery I could not feel it? I was on nearly the maximum daily dosages of zomorph, gabapentin, amitriptyline, paracetamol and oramorph - I have reduced my pain relief this week in line with the post-op recommendations.
I still feel no bladder sensation and struggle to urinate. I have to strain and it takes ages sometimes to initiate flow. I am on laxido, lactulose and senna tablets daily to prevent constipation - if I forget to take this medication even for one day/dose, I become painfully constipated and it can take a couple of days back on the meds before my bowels begin to work again. I was having both bladder and bowel disfunction immediately following my spinal injury and prior to being put on any medication.
I have been given a follow up appointment with my neurosurgeon on 20th July, so it looks like it's waiting game till then but I intend to maintain a daily diary of my symptoms/progress till then.
You are doing what you can and the daily journal is crucial. You have the symptoms of neurogenic bowel and bladder and those do not result from sciatica but are associated with CES and cord injuries. I keep a good thought for your improvement.
I still have another disc which has slipped slightly at the L5/S1 level - this was not operated on.
I still don't have any urinary sensation, unable to tell if I need the toilet and have to remind myself every couple of hours to empty my bladder. I have recently had a couple of close calls during the night where I nearly wet the bed - this worries me greatly. I still struggle to pass urine, it takes time to initiate flow and feels as though I have to force it. My bowels only move every 3-4 days and it can be very painful to pass a stool, I have to really strain. I continue to have a numb patch of skin on my outer left thigh and sciatic pain down both legs on occasion. My lower back muscles go into painful spasm every time I move. I have recently started to feel a strange sensation in my perineal area - the only way I can describe it is like having a wet sponge stuck between my legs; this sensation comes and goes.
As a result of my symptoms, my physiotherapist was reluctant to schedule any further sessions with me till I was reviewed by my consultant. I was due to meet with my consultant on 20th July but this was cancelled by his office and a letter was sent to me rescheduling the review for January 2018!! My physiotherapist advised me to contact my consultants secretary who relayed my symptoms to him and as a result, I am now booked in for an MRI on the morning of 31st July and will meet with my consultant to discuss the result that afternoon.
With luck this MRI will clarify a diagnosis that makes more sense. I looked up the Mayo Clinic definition of sciatica and it is exclusively about pain related to that nerve. Now, you may well have sciatica but that diagnosis does NOT cover your urinary and bowel symptoms. I suggest you copy and past several definitions of sciatica, then ask the doctor to guess at reasons for the discrepancy. It may be that no cause is identifiable on the MRI and it is a great weakness of modern diagnosis that doctors insist it must show up in the images. Sometimes it does not but the symptoms obviously do not lie.
Meanwhile I suggest you learn the methods those of us with neurogenic bowel and bladder use to manage things. You should NOT be left without guidance! What you suffer is completely normal for neurogenic bowel and bladder.
Post by kilg0retr0ut on Jul 19, 2017 15:12:20 GMT -8
I agree with Tetra, and I find I usually do. Excellent advice Avah1969, I remember the sponge or in my case a golf ball, it eventually went away. This and the B&B issues seem like the signs of more than sciatica. I too hope the new MRI will show something that may have been missed.