Marie:
My experience was almost identical to Carianne's. Both places were informative, interested and responsive to my many questions. While I was researching insurance and taking the time to weigh my options, LSI contacted my weekly and were quite relentless in getting me to commit.

As soon as I told them Bonati will at least work with out of network insurance, they responded with some negative comments in an attempt to raise some concerns and questions to place them in higher regard and then stopped calling and emailing me.

Bonati, however never said anything about LSI. They took the higher path. That impressed me. The few questions I had, were promptly answered and when I told Bonati, I'd probably see them next summer, they were fine with that decision.

Hope this testimonial helps.
C

Carol, There is no question from all that I have read and heard from people that it would appear Bonati seems to be the kind of place we all tend to look at with approval, for multiple reasons. Thankyou for your observations of the two laser places.

Carol, are there any undercurrents in your mind that would make you choose not to procede with surgery at Bonati or a laser center closer to your home? Or would you continue as you are for some years to come with injections and possibley meds as long as nothing more serious occurs?

I am weighing laser surgery because I don't want to take large doses of the various pain medications for the rest of my life. Each one of them have unpleasant side effects whether they take the pain away or just take the edge off the pain. Others tell me that even with surgery I may still have to take meds if the surgery isn't 100% .

Do you have doubts about the Institute handling your spondy in the light of your other spine problems.
I read on the outdated Bonati Forum the question from a person who was concerned about the "progression of spondy after surgery." The person responsible for answering the question of concern said that the doctors handled many spondy cases and although they would not say 100% that the spondy would not progress, they would say it was less likely to progress.

I thought that was a very interesting statement. The Neanderthal surgeon who I saw last, said there were no cases where the spine totally collapses on a person. After he said that, I left thinking, well if spondy doen't pregress dramatically and in the future doesn't press on any major nerves, then why the insistence on rods and bolts that many surgeons are trained in and encourage ruthlessly. Why not just free the dang impinged nerve or nerves by a lamenectomy of the vertebrae as the Bonati procedure claims to do.

I drive myself nuts with questions like this. They have no answers because no doctor is going to tell me that "I am going to be fine now and in the future.

And then there is my husband who keeps telling me to deal with the pain devil that I know and not the one that I don't know.

Quibble, Quibble, Quibble. I guess I am being a namby pamby.

Marie B.

Hello Carol,

Seems like it has been awhile since we last communicated. I hope your epidural is helping you, especially now that school has begun.

I'm with you in that I just have a better feeling with Bonati than LSI, unforunately Bonati won't accept Medicare and LSI will.

RichT

Hello Everyone,

I saw my PM doc yesterday - A "crick" in my back (pulled muscle). Told me to use cold packs rather than a heating pad. Must say the cold pack REALLY helped.

I also told him that I have good days, and not so good days pain-wise. He recommended that I take Darvon when I had a "bad" day. WELLLLlll after reading the info from the pharmacy, and some on the internet I'm not so sure I want to start taking it.

SOOOooooo has anyone taken Darvon? And if so did it help, and did you have any bad side effects?

Thanks

RichT

Rich T
I could never take Darvon because I was allergic to it.

There is another type of Darvon called Darvon Compound and there is a Darvon 65. These drugs were made by (Lilly) in past years. It's been around for a long long time.

Some years ago, I bought a book titled Worst Pills, Best Pills by Sidney M. Wolfe, MD. I got it to monitor my Father's medicines. The book's minor title is "The Older Adult's Guide to Avoiding Drug-Induced Death or Illness. It provides information on 104 Pills older Adults should not use and it covers 183 Safer Alternatives.

This book states about Darvon. (Propoxyphene)

"Propoxyphene is a narcotic that relieves mild to moderate pain. We recommend that you do not use it because it is no more effective than aspirin or codeine and it is much more dangerous than aspirin. If you have taken aspirin for your pain and it has not worked, propoxyphene will probably not do any better. In fact some studies say that propoxyphene by itself is no more effective tha a sugar pill (plecebo). Most studies show that propoxyphene is less effective than aspirin and that it has a potential for addiction and overdose.

Many people who have taken propoxyphene have become addicted to the drug without knowing it. Thousands of thes people have died, some through accidental overdoses. Several experts on drugprescribing for older adults have recommenced that propoxyphene not be taken by this group."

I provide this for your infomation only and ask you to remember that I am not a doctor or a pharmacist.

Maybe others might have more info for you.

Marie B

Hello Marie,

Thanks so very much for your most informative reply. Your reply "seals" my decision - NO Darvon.

I was reading similar things about Darvon on the internet, but when you and others "speak" on this thread I "listen".

WOW Marie, you are one very SUPER lady!!! THANKS!!!

RichT

Rich,
Good move. My PCP describes Darvon as this "an expensive drug that may or may not activate the placebo affect in pain control, but it sure doesn't work, can get addicted to and kill you."

PM doc I saw for the epidurals doesn't have it in his vocabulary and a local major teaching hospital in the are doesn't even stock it in their hospital our out patient pharmacy.

Fran


PS. Welcome Back Rich, our Fearless leader.

Marie said "Does anyone...perhaps Fran, know what is considered a "too high" dose for Celebrex? I know they recommend keeping to low doses such as 200 mg or 400 mg. I wonder if the powers that be would look at 600mg as too much.
I am having some help with the pain with this amount of Celebrex.
Marie B. "

Marie, I don't know any more about Celebrex than you can find on line in a google search.

It isn't a drug that I would have in my home or anyone in my family would use since you can't take it if you are allergic to Sulpha drugs, have asthma or a seizure disorder or have heart problems. That rules my entire family out. Both kids and myself are anaphalactic to sulph drugs, hubby has a seizure disorder, daughter and I have asthma, and son has mitral valve problems.

From what I saw on line you are taking more Celebrex than is reccommended to take for any pain relief except for FAP (familial polyposis). In FAP it is used for more than just pain but for a treatment for a potentially life threatening type of cancer.

Marie, if you are taking that much Celebrex, I would have my doc give me something different to use. Celebrex is a drug that is not worth the risk to take, IMHO.

Fran

Good Morning Marie,

Because of arthritis in my fingers a number of years ago, My orthopedic doc had me try 5 or 6 different medications for arthritis in trying to find the one that best worked for me. Celebrex was one that I tried for about 2 weeks. I did not have any adverse effects from Celebrex, but I should also mention that I do not have the "difficulties" that Fran mentioned.

After the experiments with the 5-6 medications the one that worked best for me was and still is Voltarin. Each person has to determine what works best for them. I have been taking Voltarin for 12 years now with not problems.

I'd suggest you speak with your doctor about Celebrex and your medical history and get his thoughts.

RichT

Good Morning Fran,

Thanks for your added validation of the evils of Darvon. On a bad day I may try one as an experiment to see if it helps the pain any, but that will be it, ONLY one.

Enjoy the day!

RichT

Rich, What dosage of Voltarin do you take? Is this a specific drug for your arthritis? You don't take this for purposes to relieve the pain from your spine, do you? I was confused a bit reading your responses to Fran and me.

I have never been diagnoses with arthritis of any type. That's why when I had my MRI of the spine and saw the report, I was surprised to see the Facet degeneration noted.
When a young doctor who worked with my Pain Management Dr. said to me that I had arthritis of the spine. I thought it was a ridiculous statement at first. No arthritis noted anywhere in my body by any doctor,ever, but the 4th and 5th vertebrae may have it. Now that's what I call a "specific" arthritic joint.

I never needed any type of meds for arthritis and yet I know many of my friends and acquaintances are taking pills all of the time for that diagnosis.

Fran, in regard to my taking Celebrex, I have found post op, narcotic drugs do not provide me pain relief. But give me a good anti-inflammatory and I'm up and running. I don't know why. After one major abdominal surgery, anesthesia Dr. was giving me morphine via intervenous and for the first 24 hours I was miserable, in pain and fuzzyheaded. My gyne surgeon came in and after I told him my problems, he stopped the morphine, and put me on Toradol. It was like a magic pill. Within a half hour pain was gone and I was moving around like there was no incision in my abdomen. It was great.
Today, I have backed my Celebrex down to 400 mg. I will see if that will hold the pain. I am also seeing a second surgeon this Thursday and I will see what he has to say.

I am not allergic to Celebrex. But I didn't deal well with Darvon Compound and that was years ago when I was given it for a headache.

Marie B

Hi everyone and happy Friday! Hope you all had a good week! I've been home a week already and can't believe how fast time goes by.

I was suppose to go back to work Monday, but just don't feel like I'm ready yet so I requested an extension to my short term disability. I still have a bit of stiffness in my back and some pain in legs which makes me nervous. I'm just praying that it goes away as the nerves heal.

Of course, there's a possibility that I may need more done, but my body tells me to give it a few months and see how I am come next year. Dr. Bonati did say what I feel is normal and it will eventually go away.

Hope you are all doing well and your pain is at a minimum! God bless you all! You're certainly a strong group of people!

Carrianne

Hi everyone,

I have a question....

Regarding a nerve study that was done....what does it mean ''suggestive of a lesion along the somatosensory pathway between the right posterior tibial nerve and the left cortex"? Clinical correlation is required.

I've tried to search this one .........but way to much comes up that is all greek to me. Just wondered if any of you may have had a nerve study done and had experienced any of the similar results or possiliby close to this..........
Always.........mj

MJ,

I'll take a stab at this one for you, but remember, I'm not a doctor, just going on "some medical knowledge and anatomy and physiology.

First of all the word lesion is a funny word when it come to medical terminology. It has several meanings from a tumor, plaque in your arteries and damage or nerve compression.

In your case, if I remember correctly, we are talking about spinal stenosis stuff, so that the "lesion" no doupt refers to how the nerves are functioning or not functioning well.

So here goes with what "I think this means".

The tibial nerve is a branch of the sciatic nerve that comes through the spinal canal through the L4,L5,S1,S2 vertebrae. The sciatic nerve goes along the butt and goes down your thigh, where it branches into the tibial nerve that goes along behind your lower leg. It brances further down again at the ankle into the plantar nerves of the bottom of the foot.

Compression of the nerves in the L4,L5,S1,S2 causes the pain of spinal stenosis, that horrible pain in the butt, going down the thigh, leg, ankle and into the foot. When the compression is released with surgery, or the spinal injections relieve some of the inflammation, the nerves have a chance to start to heal.
Depending on how long and how bad the compression has been, there can be damage to the nerves that just can't be healed.

The tibial nerve, itself, is responsible for supplying movement and sensation to the calf and as it branches to the plantar to the ankle and foot.
What's called "messages" are sent between the nerve to the brain, the cortex part of the brain, that tells the brain to respond to various sensations and movement. Things like pain, burning feeling, tingling, feeling in that part of the leg, ankle and foot.
If there is "damage" to the nerve, then the messages are not getting through to the brain correctly and that part of the leg, foot, ankle doesn't respond correctly.
That could mean reflexes are off or not there at all, pain is felt from compression of the nerves, only deep pain is felt and gentle touch is not, etc.

"''suggestive of a lesion along the somatosensory pathway between the right posterior tibial nerve and the left cortex"? Clinical correlation is required."

This probably means that the tests where not conclusive but suggest that the "nerve messages" may not be getting to the brain correctly along the pathway that it is supposed to from the right tibial nerve to the cortex of the brain. A physical examination of the patient and the patients response to the area of the body in question would help to confirm what the EMG possibly showed.

I hope that helps, but as I said, I'm not a doctor, but do have some medical knowledge and anatomy and physiology knowledge.

Fran

Thank you , Thank you, Thanks you.........Fran.......you have put my mind at ease....you explained to the tee.......what I feel. I'm so glad to have found this site and such great people.

Could this also be the cause of...........when walking you realize that your foot just drug the ground ........when you thought you are just doing a normal function of walking? (make sense)......but you know something was'nt quite right??

Once again Fran......Thanks!!

mj.....

Yea! MJ, I'm glad Fran picked up on your question quickly to respond so very succinctly. I was in the process of trying to minimize the answer to your question and there Fran was, johnny on the spot, with the details. The shortest thing I could come up with was "There is something blocking the messages the lower body was sending to the brain." Trying to put in all of the details of the Anatomy and Physiology of the effected parts caused every paragraph I wrote to be too wordy.

Yea for Fran!
Marie B.

I heard yesterday from an acquaintance who just had spinal surgery.
The person had stenosis L2, L3, L4, L5, and S1. The stenosis was caused by multiple bone spurs. Fusion with instrumentation was done on the L4, L5 vertebrae because of the presence of spondylolithesis.
The incision was 6 inchese so you know he had the muscles cut and pulled away from the spine for the surgeon to have access to the spinal column.
The surgery was done one week ago.

The 77 year old man was up and walking the first day with support, Day 2 he was given a walker with wheels to move around the hospital. Day 3 He was released from the hospital with brace (wrap-a-round style) He ices his back every 3 hr for 20 min. routine even though he has no swelling around the incision. All pain in back, buttocks and legs were gone. He was ordered the pain medication, Vicodin of which he has taken only 3 since the day of the surgery.

He told me that he was sweeping the floor of the living room when he decided to call me to report on how he was doing. Prior to surgery, he knew that I was looking at spinal surgery and was reluctant to proceed.

He told me that it all depends on one's mental attitude on approaching this type of surgery and the trust that you have in your doctor. He said his attitude was other people have had this surgery and come out in well, so why not me? And there he is at this stage in his life...up and moving.

I am beginning to believe that people who have Facet deterioration from boney spurs which then press upon the cauda equina causing the stenosis have a better time of things post op. The Doctors just sand off those spurs and voila the stenosis is gone. If a disc has herniated and the ligmentum has buckled or a myriad of other problems then we have a whole different surgical procedure to face.

It would appear that everyone has pain in the lower back, buttocks and legs but the pain in the legs can end at the thighs, the knees, the calves or right down to the big toe when they face the fact that there is a spinal problem. But the cause of that pain, the degree and extent of that pain have very different origination problems. And here is where the trust of your doctor enters the picture. He determines the origination and advises how to procede. So the big question is "How well do you trust your doctor"?
A lot of them could not win the Mr Personality Award. But one always has to remember that a "good bedside manner" doesn't always mean you are dealing with the "best doctor."

Carriane and Joe said they still had some pain in their legs post surgery.
And they were told it would take time for the nerves to heal and then that pain would go away...and we hope for them that it all will.

Maybe we wait too long to face spinal surgery and it takes a really long time for the nerves to heal post op.

Decisions, Decisions, Decisions. We all face decisions.
Marie B.

Hello Marie,

Thanks so much for sharing the experiences of the fellow you know. What REALLY caught my eye was that he is 77 years old.

Marie, you really put some excellent thoughts down on "paper". Very good food for thoughts.

Decisions - I trust Carol will permit me to quote a part of an E-mail she sent to me the end of August - "Sometimes, I think that indecision may be the best decision. I find, that usually if I'm plagued with that reaction, the answer may be to wait and take notice of God's little signals . . . he'll direct you and you will know when it's right to act." I think of Carol's above thoughts every now and then. It gives me peace, reduces my concerns.

Take care.

RichT

Hello Marie,

Regarding the dosage of Voltaren - I take one time release 100mg tablet once a day. By the way, I spelled Voltaren incorrectly on in previous post. It is "en", not "in". What I actually take is a generic of it.

To quote a small portion from eDrugs.com website - "Voltaren is used to treat pain or inflammation caused by arthritis or ankylosing spondylitis." Being I have DDD, yes, Voltaren does help. Remember, it is an antinflamatory drug, not a pain medication. HOWEVER, reducing the inflammation wil in some cases reduce the pain indirectly. (Fran, correct me if I'm wrong.)

Marie, just wondering what your 2nd opinion doc had to say about Celebrex.

RichT

It was a good thing I copied my response below, before I submitted, as again I was "timed out" and was unable to post. I find this one of the most frustrating features on this website. How the heck was Fran able to type and submit such long posts earlier . . . I type as fast as I can and try to reply thoughtfully, which unfortunately takes some time . . . grrrrrr!

MB:
I swear you are my "spinal twin!" Mentally and physically we seem to be experiencing many of the same physical symptoms and mental anxiety. Plus we both like to ask a lot of questions!!!

I don't know where to start. . . other than I'm trying to still "wrap my mind" around the fact that I even have back problems. In "my mind" it seems like the answer is simply. Minimal invasive incision to as someone said "sand off the unwanted calification causing the stenosis or narrowing of the canal and pressure on my nerves. No fusion, no instrumentation, just a "cleaning out" of build up and I will be fine!!!

So, until I find . . . what I'm looking for, I thought my best option was to suck up the pain, deal with epidurals and keep on keepin' on . . . but, I'm now beginning to wonder, like you . . . if prolonging surgery will deal with irreversible nerve damage. My latest epidural block, seems to allow me to stand a little longer and walk like a neandrathal a little farther, before I have to sit down to relieve the pressure and or pain. Sitting down is what I do best these days . . . the thought of being confined to a wheelchair of one of those motor chairs advertised on TV makes me angry . . .

My problem is that because of the epidural block, I know I stand a little longer and push the boundaries, because the "pain" sensors don't tell me to stop. At night when I finally do drift off to sleep, I can be randomly awakened by such blood curdling muscle cramps and ankle or foot spasms, now in both legs that are probably involuntary muscle reactions accumulating from daytime activity . . . My ankle and foot can become so contorted that it is quite scary.

When I have time, I am constantly searching for something closer to home . . . but it will entail enlisting the doctors in the larger Dallas metroplex. I'm afraid Sherman just doesn't have the talent or answers for me. I am encouraged by my local pain med doctor that he agrees with me to keep a graduated approach, with levels of surgery as the last option. I'd like to hang on with the epidurals till next summer. Then, I will take the bull by the horn and be in a position to make a surgical decision. Hopefully I will be in a better place to decide what options are best for me. So, I haven't ruled out laser surgery. Infact, I'm 75% sure that this will be my response.

Rich T: I believe either LSI or Bonati will be fine for laser surgery. If LSI can provide you with Medicare relief, I too, would be considering them. The thing I like about LSI is that they combine surgeries and you seem to be under only one time . . . So both places cost the same amount of $$$, with Bonati insisting that they do one procedure at a time. This can be viewed both as being cautionary or just another way to arrive at the same financial endpoint. Either way, we go in with good faith that we come out intact. I believe both places operate on that basis.

The underlying problem is that with age, our symptoms will eventually come back . . . so we are all at different places in this journey. There is not life long guarantee by ANY surgery to solve all future problems. Sometimes I wonder if it is realistic to think that we will be magically free of all pain. Heck, even as a younger woman, I realized different levels of what is now my advancing stenosis . . . I just didn't know it!!

I try to keep the meds to a minimum, because it makes me very mentally foggy . . . but I've got a super pain tolerance limit, or I'm just plain stupid. I haven't quite figured that out.

Rich T: I got to do some "sprucing up around the house" today and felt wonderful to be out trimming and weeding etc. It was an absolutely gorgeous TX morning . . . but I was only able to do about two hours worth before I had to stop. This I've decided is better than nothing!

MB: My only question right now is that by keeping the epidurals going and blocking pain, I sure hope I'm not causing more nerve damage that can later not be undone . . . my gut is telling me that is exactly what I'm doing. I think there is a small window of opportunity that we have that diminishes and will result in narrowing our surgical options down the road.

Fran: That was an awesome response to MJ57!!! we are fortunate to have your knowledge shared on this forum!!!