Carol, Oh my goodness, oh my, you are having some serious problems and I have to agree with Marie, it doesn't sound like you can wait till June.
Someone up there had me leave my computer on and when I went to turn it off, I saw your post and have read and reread it several times.
So, in response, Carol, you are dealing with some serious nerve compression problems and it sounds like it has been going on for quite a number of months and maybe years. Actually it has been years that the nerves have been compressed. It is only when the compression becomes severe that we begin to feel the pain and nerve problems.
Your description of your self sounds identical to me before I had surgery, so I understand that you are not having a fun time with it.
You may or may not have foot drop right now. It sounds more like the main and nerve compression has become so bad that you are just unable to use your leg and thus just drag it. You inability to stand on your toes is all part of moderate to severe L4,L5,S1 spinal stenosis, not always foot drop. It can be the beginning of it though.
I'm assuming you are referring to you toes when you talk about the "peds". that sounds like the nerves in the bottom of your foot have now become affected and you may very well be talking about tarsal tunnel syndrome, which is actually carpal tunnel of the foot; and yes, that pain may only last a few seconds but it is some of the worst I have ever felt as well.
That can be a complication of suffering with spinal stenosis for so long and not walking correctly and it can be come a "side affect" of surgical correction of the stenosis and the feet having to learn to walk correctly again after the surgery. That way I know well, as I had that happen to me after surgery.
Your symptoms with the toes are classic and will not get better until the stenosis is corrected and you have PT for both your spine after surgery and your feet, along with custom orthotics and good walking shoes.
The reason you are more comfortable in the curled up position in your chair is classic response to spinal stenosis. By sitting this way or bending over when you stand and hold on to a shopping cart, is that it provides more space in the spinal column and the vertebrae, hence there is some relief of the pressure on the nerves.
The fact that your right leg is giving out on you w/o notice and you are falling is, by far, a very serious sign that your stenosis is progressing and not only causing further compression on the nerves, but may in fact, be causing permanent damage to the nerves, and that can become worse without relieving the compression.
ESI don't really mask symptoms and pain as long as a steroid is used. It helps to decrease the inflammation with the nerves. By decreasing the inflammation, the nerves become less swollen and inflamed. What it doesn't do is correct the stenosis. Only surgery will do that.
Are you creating more of a problem down the road by continuing to get the ESI? Yes, in that you are doing nothing to correct the problem, only relieving some of the symptoms on a temporary basis, but you are still leaving the nerves compressed. Yes with that continued compression on the nerves, it is possible to develop permanent damage to the nerves. Yes, in that over time, it is possible to build up a tolerance to the meds used in the ESI and they will no longer help you or help you to the degree that they have in the past. Yes, in that, every time you have an ESI, you are involved with risks of complications and side affects. Those side affects can build up in the body over time and really create havoc in you body. Yes, for every year that goes by and you do not have surgery for the stenosis, you become a year older. A year older that makes surgery just a little bit more difficult to have and recover from, simply because you are a year older. And Carol, you said you are an educator, ESI is using steroids and those steroids stay in your body or several months. It does lower your resistance to infection and being a teacher, you are exposed to far more germs from the kids than the rest of us are.
Those injections also can cause elevated blood pressure, temporary loss of bladder and/or bowel function, vision problems, increased blood sugar levels and many other things.
Don't get me wrong, I'm not against ESI at all. I had 3 of them before my surgery and they had no real affect on me, no relief of pain. 24 hours on the first one was not relief, it was the lidocaine not the steroid. The second did nothing and the 3rd was pure torture in the amount of pain it caused.
I did recently, the week before thanksgiving, have a selective nerve block done on the nerve of the L3 Disc and it was quite successful, though I probably shouldn't say that, it might jinx me. (will explain about the disc in another post, but don't ask me about 80 year old drivers that shouldn't be driving at all).
Carol, I know that you have wanted to do laser spine surgery and have been investigating it and maybe other types of surgery for quite a long time. And I will admit I have many doubts about the laser surgery.
But my concern now is for you, not the types of spinal surgery. You have been looking into this far too long and your symptoms have become far to serious to just sit back and continue to get ESI and investigate further and wait till summer to do something about it and make a decision.
You now really need to come to terms with the fact that you need surgery and really can't put it off. These are serious symptoms that you are suffering, sounds like they are getting worse by the day and at the rate they are progressing and you have described, you will be in my shoes within in a short period of time. total loss of bladder control and an emergency surgery happening to you without being able to decide on a doctor and what surgery will be done.
When I made my decision to have surgery, it was easy. I couldn't take the pain any more and the choice was surgery or suicide. The problem was who was going to do it and what type of surgery would it be.
I wasn't an emergency in the eyes of any doctor at that point other than I couldn't take the pain any more.
The unfortunate thing was I didn't listen carefully to my doctor about what he was going to do. All I heard was general anesthesia, open surgery. I didn't hear the rest, minimally invasive, 1 inch incision, partial laminotomy, and release of the nerves in the lateral articulate.
I didn't want general, wanted to be awake, endoscopic and all the rest.
I had several other opinions, having one at that point was required by my surgeon before he would operate, and believe me, one opinion was worse than the other. These docs where from the most prestigious hospitals in Boston MA. Think mass general, brigham and womens, new england Baptist, Beth Israel/Deaconess. The docs where so bad, I wouldn't take my cat to them and believe me, my cat is part of the family and gets better care from the vet than these docs offered and seemed to have knowledge of.
I also have the advantage of medical knowledge and radiologists and docs outside these hospitals to talk with.
My MRI was read by several other radiologists besides the original and my spinal surgeon, along with the head of orthopedic surgery and sports medicine at children's hospital in Boston. Both of them very close friends of mine since I was a teen. The sports medicine doc there Lyle Micheli is the founder of the Sports medicine specialty that is now recognized.
I went from difficulty walking and horrible pain to the position you are in right now with your pain in a matter of 5 weeks. And the night before my scheduled surgery, I lost total bladder control. At that point you have between 24-48 hours to have surgery and get the pressure off the nerves before it's to late and the bladder loss is permanent. I was lucky that my surgery was scheduled when it was.
They all agreed with my original spinal surgeon, who is a sports medicine orthopedic spinal surgeon, and they told me that is the best kind of doctor to use as well as the best in his field and they would use him to do surgery on themselves. They also said they would use no other kind of spinal doctor but a sports medicine orthopedic spinal doctor.
So I'm going to encourage you to find yourself an sports medicine orthopedic surgeon that specializes in spines and see him/her. Get a new MRI and get evaluated for your spinal stenosis and possible spondy. Instead of continuing to investigate and wait till summer to do something about it. It could very well be too late.
A sports medicine ortho spine doc, does minimally invasive surgery. Yes, it's open surgery and yes, it is usually under general anesthesia. But they will only cut as much as is necessary.
As Marie said and I will agree with her, it sounds like you have waited long enough, maybe too long and you are decreasing your options as to what you may or may not have to have done, because of the wait.
You aren't even sure if you have spondy or not. You may find that you don't, but for every day that you wait, you put the risk of permanent damage to your nerves at more and more risk, and your symptoms are very, very severe.
Please Carol, don't wait any longer, at the very least, get a full diagnosis and updated tests to see what is and isn't going on. At least then, you will know exactly what you are dealing with and not wonder is it just severe stenosis or is it spondy too. What are my options, what is being suggested, does it make sense.
Sometims, waiting is the worst thing you can do, sometimes it isn't. it does sound like, in your case, waiting has been too long and it's time to take action.
Believe me, Marie and I both know how scary spinal surgery is, and though her surgery was far more extensive than mine, both of us have no regrets in having open spinal surgery done.
Like any other surgery, when it is needed, it is the best thing in the world. And this is from someone whose front body looks more like a road map than a body, from all the surgeries I've had.
Thanks to a little old lady who should never have been driving, the back side of my body is going to start looking like a road map too, as I will no doubt be facing more spinal surgery on the L3 nerves of the disc in the new year.
Do I want it no, will continued nerve blocks help, yes, but I don't want to continue having them for the rest of my life. I want the problem corrected and be on with my life.
Good luck and Merry Christmas. Let the new year bring you some answers to what is going on and a rapid decision on what to do
Fran