Tuesday, May 28, 2013

What is an MRI?

MRI MachineWhen I went to my primary care doctor shortly after I re-injured my back in 2009, my doctor sent me off to have some x-rays taken.  Of course, I know that x-rays don't always show the real picture and often don't give doctors a real picture of the damage.  X-rays are designed to show doctors problems with the bones.  When the x-ray results came back and they revealed that I already had arthritis and disc degeneration going on in several areas of my spine.  However, they didn't show my doctor what was causing my lower back pain.  I asked my primary care doctor for recommendations for a specialist in orthopedic medicine and spine care.

Disclosure:  This post is for informational purposes only and the opinions reflected in this post are my own.  Your opinions may differ from my opinions.  I am not a doctor or health care provider.
 


After my initial visit, the orthopedic doctor that I saw sent me to have an MRI done on my back.  An MRI is a simple test that uses magnetic field and pulses of radio wave energy to generate a picture of your organs and body structures.  MRI's typically show information that can't be found on any other test such as X-Rays, CT Scans, and Ultrasounds.  MRI's were typically done in the hospital but now you can find independent diagnosis center who can perform an MRI, while saving you money.

I was nervous when I went in for an MRI because I wanted it to reveal my source of pain.  I was scared that the MRI wouldn't reveal any information or give the doctor any indication of my pain.  The technician came out and called me back to get started on my test.  I had to change out of my clothes and remove anything metal that I had on.  They allowed me to lock my belongings up in a locker and take the key into the room where the MRI machine was at (they did this same thing at the hospital that I had an MRI done at as well).  Then the technician had me climb up onto the table.  If you haven't every seen an MRI machine before, it looks like a hard bed that moves in and out of the machine and a curricular donut looking tube that they move you into so that they can perform the test.  

Once you are on the table, it is important that you don't move and follow the instructions of the technician.  If you are claustrophobic, you might want to mention this to the technician because there isn't much room around you inside of the tube.  The office that I went to had headphones and put on my favorite radio station while I was having the test performed.  The music helped drown out the noise from the machine, I will be honest it is loud and you can hear the machine spinning and pulsating around you.  At the hospital, I didn't have the luxury of listening to music while they perform the test but I tried to sleep while they were performing the test.  

If your doctor has ordered an MRI and you are on a budget, I would suggest that you use an independent MRI facility.  They are typically a 1/3 of the price that the hospital will charge for an MRI.  Most insurance companies will pay for independent MRI diagnostic centers, check with your insurance company to find a list of providers that can perform the MRI.

Have you had an MRI done?

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Tuesday, May 21, 2013

What is a Discogram and Is It Painful? - My Experience

IV in Hand for DiscogramWhen my doctor suggested that I have a discogram done to help figure out where my back pain was coming from since my MRI didn't reveal a clear picture of what is going on with my disc at L5-S1.  I came home and immediately started researching a discogram procedure so that I would be fully educated before I made the decision have the test done on my back.  In December of 2011, I decided to go ahead and have the discogram done since I had maxed out my medical benefits.  So my doctor ordered a discogram.  The discogram was scheduled for an outpatient procedure at the hospital.  The test does require a small dose of anesthesia to help you relax while your doctor performs the test, so you won't be able to eat or drink anything before your procedure.

Disclosure:  This post is for informational purposes only and the opinions reflected in this post are my own experience   Your opinions may differ from my opinions.  I am not a doctor, health care provider, or pharmacist. 

My test was scheduled during the late afternoon so I wasn't able to eat or drink anything before the procedure.  In fact, most doctors prefer to take care of patients who have other medical issues such as diabetes or blood pressure issues first, so if you are scheduled later in the day don't be surprised or alarmed.  I arrived at the hospital and got checked in.

The nurses called me back to a room and took my vitals.  It seemed like I waited forever for my doctor to arrive, he came to talk to me before he did the procedure.  Then once he finished, the anesthesiologist came in and asked me a bunch of questions.  Make sure that you answer the questions honestly to avoid possible interactions.  A nurse will place an  IV in your arm and begin giving you fluids before you go back for the test.

When the doctor and anesthesiologist are both ready to perform the discogram, you will be wheeled into a room that looks similar operating room and it has a high tech x-ray machine.  The anesthesiologist gave me a dose of antibiotics to help prevent infection.  After the dose of antibiotics, I was given a mild sedative so that I was relaxed but still alert enough to be able to talk to the doctor.  They want you to be relaxed but awake  so that you can tell the doctor what you are feeling while he performs the test.

The doctor cleaned my back with iodine and laid the blue paper over my back.  Then he took a needle that was filled with dye and inserted into my back.  The doctor uses a high powered x-ray machine called a fluoroscope, it is a high-tech x-ray machine that allows the doctors to be able to see where they are injecting the needle into the spine.  Then the doctor guided the needle into L5-S1 disc, my disc that appeared unhealthy on my MRI.  When he injected the dye into my disc, I immediately felt that all too familiar pain that I have been feeling on a daily basis.  I knew that this was where my pain was coming from and the source of most of my back pain.

My doctor decided to inject L4-L5 as well, to make sure that I was in fact feeling the pain from just one disc.  When my doctor injected into this disc, I only felt pressure and it wasn't painful at all.  This means that this disc is fairly normal.  After he finished, I was immediately transferred back to the rolling bed and sent off to have a CT Scan.  

A CT Scan is performed so that your doctor can see the discs clearly after the dye was injected.  A CT Scan doesn't take very long and is a high powered x-ray machine that takes cross-section photos.  Once you are finished with the CT Scan, you will be transferred to a recovery room.  While in the recovery room, the nurse comes in and takes out your IV.  You will also be offered something to drink, while you wait on your CT Scan films.  You can also get dressed. 

I was released after I was able to keep my drink down and no longer felt dizzy.  They wheeled me out in a wheel chair to the car and sent me home with some pain medication.  I expected to be very sore after the procedure based upon other people's experiences that I read about before I had the procedure done.  However, I remember feeling a bit sore but I didn't feel worse than what I do on a normal day.

A discogram is a diagnostic procedure that doctors perform to find out if you have a problem with your discs in your spine.  During the discogram, it is important that you concentrate on what you are feeling so that you can explain what you are feeling to your doctor.  You are looking for that familiar pain that you experience on a daily basis.  When your doctor injects the pressurized needle that is filled with a harmless dye.  Your doctor will then inject the dye into your disc that is suspected to be causing you pain.  There are only three outcomes for this test:
  • You feel pain
  • You feel pressure
  • You feel nothing
If you feel pain, explain the pain to your doctor.  Does the pain resemble what you are feeling on a daily basis or is it a different type of pain?  

I hope that this post has been helpful.

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Have you been told that you need a discogram?  

Sunday, May 19, 2013

Three Doctors Three Different Opinions on Whether Back Surgery Would Be Beneficial

Low Back PainMy sinus infection seems to finally be gone and I didn't start feeling normal again until Friday.  Thank goodness because it was rough not feeling good for an entire week.  On Friday morning, I went to see my orthopedic surgeon since it has been a while since I have seen him.  He sent me to a pain management specialist for treatment and didn't want to see me back until I was finished with his treatment plan.  I haven't seen my orthopedic doctor since October 2011 and I wanted to update him on my condition.  Plus, I wanted to know what his opinion was on my back since I have had two doctors telling me two different things regarding back surgery.

Disclosure:  This post is for informational purposes only.  The opinions and information in this post are based upon my own opinions and experience.

The visit went well but I left his office even more confused than ever.  He said that I was a good candidate for surgery if my insurance was willing to pay for it.  He said that I would need another MRI to confirm what type of surgery would be best based on the new the MRI results.  It has been about 18 months since I have had an MRI.  He said I have two options: spinal fusion or disc replacement.

The thought of having surgery at this point terrifies me and my gut instinct tell me that I would probably end up having multiple surgeries if I had surgery on my back.  I don't have any nerve pain at this point but if I did I wouldn't second guess having surgery.  I really just want to avoid having multiple surgeries n my back just like my grandmother.  She has had multiple back surgeries on her back and the surgeries never fully took her pain away.  I don't know what her surgeries were for or what caused her to have surgery in the first place.

My surgeon thinks that having surgery would resolve my pain and that the chances of making my pain worse is fairly slim.  However, my pain doctor said that a surgery would only give me a fifty to sixty percent chance of recovering from my back pain.  Then you toss in the state doctor's opinion.  The state doctor told me that he wouldn't recommend that I have surgery on my back because the disc above L5 wasn't fully healthy and that if I did surgery it would put too much pressure on the disc above resulting in the same type of pain years down the road.  My orthopedic surgeon disagree with his diagnosis and thought that my L4 was healthy enough for surgery but wanted to confirm that via MRI.

Yikes, three different doctors and three varying results.  I hate to keep going to the doctor for verification on the outcome of my back.  I want to avoid having surgery if at all possible but I also believe in  having a quality of life that is worth living.  If I had two doctors that gave me similar information then it would make the decision to have surgery or not on my back easier.

I have tried researching and talking to people who have back issues that are similar to mine to get their opinion, even though I know they aren't a doctor or seen my MRI.  I am just looking for success stories.  So far what I am seeing, is people have about 50% success rate.  If that is the case, then is surgery really worth trying?  It is all so confusing.   

The only alternative option would be to place a spinal cord simulator in my back to help relieve the pain so that I don't have to live on medication the rest of my life if I decide surgery isn't my best option.  Of course, this is another option, if I end up with a failed back surgery.

My main source of back pain comes from my L5-S1 disc in my lower back.  However, I also have arthritis and disc degeneration in upper back as well.  I wish that I never listened to the doctor's advice over 10 years ago when he told me that my MRI didn't show any significant damage and that I was young and would heal.  Here I am years later and my situation never improved.  I wish I would have pressed the issue then to find out the source of my pain.  Of course, that doctor thought I mostly had muscle injuries and that there wasn't anything wrong with my spine.  I realize that I am not a doctor and my long term muscle damage could have resulted in disc problems due to my body making compensations for sore muscles.

I have to seriously think about whether or not surgery is the best option and try to decide if it would be logical to seek another opinion.  I am just afraid that I would have a fourth doctor tell a totally different opinion.

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What made you decide to have back surgery?  If so, was your back surgery successful or not?

Wednesday, May 15, 2013

Prevent Possible Drug Interactions - Ask Your Doctor If the New Prescription Will Interact With Your Current Prescription

HeadacheI apologize that I haven't kept up with my blog over the last few days, I was woken up by a pounding headache at 4 am on Saturday morning.  This headache wasn't your typical headache, it was one that felt like your head is going to explode from all of the pressure.  I tried to go back to bed after I took some over the counter medication but my head was pounding and I started feeling nauseated from the pain.  So I grabbed my microwavable moist heating pad and heated it up in the microwave.  This seemed to help ease the pain and I was able to go back to sleep.

Disclosure:  This post is for informational purposes only and the opinions reflected in this post are my own.  Your opinions may differ from my opinions.  I am not a doctor, health care provider, or pharmacist.


 

When I woke up my headache was gone but a few hours later I it felt as if it was going to come back at any moment and I wasn't feeling very well.  My husband convinced me to go to the doctor since my face was tender to the touch when I had my headache.  So off to the doctor I went.

The doctor said that I had a pretty serious sinus infection, in fact, after several days of antibiotics and a steroid shot I am still not feeling normal yet.  When he started talking about prescribing medications, I immediately asked him what he was planning on giving me.  I wanted to make sure that it didn't have any interactions with my other medications.  I am glad that I asked because he was planning on giving me something that contained the same drug that I was already taking for my chronic pain.  This could have been dangerous to my health.

It is important to make sure that you voice the medications that you are taking, especially, when the doctor that you are seeing isn't familiar with your chronic condition.  Even though most doctors offices, will ask you what medications you are taking.  It doesn't mean that the doctor treating you paid attention to the noted medication in your chart.  It is best to speak up and tell the doctor what medications that you are taking to avoid possible drug interactions so that he can prescribe something that is compatible with your other medications.

Using the same pharmacy for all of your prescriptions can help catch the drug interactions.  However, if your main pharmacy is closed, the pharmacy you are filling your new prescriptions won't have all of your medication history and might miss possible drug interactions.  If you have any questions or concerns about possible drug interactions, be sure to ask the pharmacist who is filling your prescription.


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How do you avoid possible drug interactions when seeing doctors who aren't familiar with your chronic condition and the medications that you are currently taking?

Thursday, May 9, 2013

What are the Advantages of Keeping a Pain Journal to Document Your Chronic Pain Symptoms?

Doctor writing down notes in your chartMost people with a chronic illness will need to see a variety of doctors on a regular basis.  This is important not only for your continued care but it is a way for your doctor to really get to know you and your case.  When you go to see any doctor, make sure that you are honest and tell them everything that is going on with you when it comes to your illness.  In fact, I like writing down things so that I make sure that my doctors knows about it.  Often times in the heat of the moment, you forget to mention something important to your doctor.  Having it written down keeps you from forgetting to tell your doctor important information.  Some people find it helpful to keep a journal and write down daily synopsis of their daily activities, especially, when it comes to increased pain or new symptoms.

Disclosure:  This post is for informational purposes only and the opinions reflected in this post are my own.  Your opinions may differ from my opinions.

A journal can be useful for several purposes and can be used to help your doctor to determine your pain triggers.  When you are adding entries to your journal make sure that you include the following items:
  • Type of activity that you were doing - Be as descriptive as possible.
  • Rate your pain - Use the pain scale that you often see in your doctors office to rate your level of pain.
  • Use descriptive words to describe your pain -  Jot down if your pain comes and goes, feels like pins and needles, muscles spasms, or constant.  
  • Location of the pain- Describe the exact location of your pain, especially, if it isn't always in the same spot.
  • Note the Time of Day - Writing down the time of day will help your doctor determine when your are most like to see a spike in your pain levels.  Of course, it is possible that your pain varies on a daily basis but your doctor is looking for specific times during the day when you see a consistent spike in pain.
  • Treatment - Write down what you did to help reduce your pain.  ie - take pain meds, if you used ice or a heating pad, did you have to lay down,  or take a break, massage.
When you go to your doctors appointments, make sure that you take your pain journal with you.  If you keep your pain journal on the computer, you should print out a copy and give it to your doctor.  Make sure that you sign it and put a date on it so that it shows the date that you gave it to your doctor.  This can help prove any deterioration of your health or allow your doctor to see when any new symptoms began.  A journal also allows you to communicate with your doctor beyond what you tell him during an office visit (often the visits only last a short amount of time).

Keep a Copy of all Important Medical Documents in a File Folder


I have found that it is important for me to carry around frequent medical documents so that I can easily bring them to all of my doctor's appointments and meetings.  I bought one of those plastic file folders to sort my documents so that I can easily find things.  It is nice to be able to pull out a document and hand it over to a doctor so that he can view it or make a copy of it for your medical chart.  For example, I went to a state doctor and I had a copy of the doctors report in my folder.  I was able to quickly pull this document out and allow the doctor's office to make a copy for my doctor to read over and  file into my chart.  It is also great for taking on job interviews or meeting with people who are helping you look for jobs as well.

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Example of the file folder that I purchased to keep my medical documents in.





Tuesday, May 7, 2013

Sleep Deprivation Can Increase Your Symptoms and Make Your Chronic Pain Feel More Intense

Sleep Deprivation and Chronic PainPeople who deal with chronic pain often times struggle with getting enough quality sleep, I know that I personally have trouble falling asleep at night because I can't seem to find the right position  or I can't comfortable at all.  I hate tossing and turning in the bed at night because I know that it interrupts my husband's sleep while I attempt to find a comfortable position to lay in.  So I end up laying in one position for a while, even if it is uncomfortable, before turning over again in the attempt to find a more comfortable position.  When I can't sleep I often times will play games on my phone, chat with my followers on Twitter, or read a book.  This irritates my husband to no end.  I don't do it on purpose and I would go to sleep at a decent hour if I was able to get comfortable and actually fall asleep.

Disclosure:  This post is for informational purposes only.  I am not a doctor, health care provider, or counselor.  If you have any health concerns, please talk to your doctor immediately.  The opinions reflected in this post are my own and may differ from your own opinions.

I remember when I was pregnant with my youngest, most people are aware that women who are towards the end of pregnancy often find it difficult to get a good nights sleep.  If you recall when you were 8 or 9 months pregnant, you too couldn't find a comfortable position to sleep in, you toss and turn to find a somewhat decent sleeping position, or you are suddenly woken up by hip or back pain in the middle of the night.  This is how I feel every single night even though I have given birth to my son almost two years ago.  I came up with this analogy in hopes that women might be able to somewhat feel what I go through each and every day.  Granted pregnant women eventually get to end their pain, suffering, and sleepless nights for the most part after they give birth to their baby.  However, my problem is constant and ongoing.

When I can finally get to sleep, I usually have to wake up in a few hours and get my kids off to school for the day.  This not only interrupts my sleep schedule but it also annoys my husband because I end up going back to sleep for a few hours during the day.  I wish I could find a happy medium and a balance but rest/sleep is very important.  In fact it is important that your body get quality sleep so that you experience the deep sleep stage which is necessary for proper mental health.  Sleep also helps promote healing and leaves you feeling refreshed and well rested.  When you bordy is in this deep sleep phase, often referred to as rapid eye movement or REM, your body not only makes you feel better physically but it also helps people cope with stress more effectively, helps you recover from illnesses or pain, and helps you solve problems (promotes healthy mental health).  

If you are sleep deprived, you are not only physically tired but it can cause you to suffer from other health issues including depression, anxiety, and other mental health issues.  Not getting enough sleep can impair your ability to analyze and solve problems, increases your pain, makes you feel more fatigued, decreases your ability to fight off illnesses, delays your immune systems response time, can increase your symptoms of depression, and can impair your memory.

Don't continually deny yourself sleep or use caffeinated drinks to constantly cover up your sleep deprivation.  Continual sleep deprivation is not only bad for your overall health but it increases your pain symptoms (as if they aren't already bad enough) and affects your moods.  I know that I am more cranky when I am tired.

Take care of yourself, you only have one life to live.  Dealing with chronic pain isn't easy but it is important that you know that you aren't alone on this journey.  If you are feeling alone, please find me on Twitter or leave me a blog comment, I will do my best to help connect you to an online support group or help you find additional resources in your area.

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Genesis 2:18
The LORD God said, "It is not good for the man to be alone. I will make a helper suitable for him."   

Do you have trouble falling asleep at night?  If so, how do you overcome your sleep problems?

Thursday, May 2, 2013

Does Weather Changes Really Affect our Pain Levels?

http://www.freedigitalphotos.net/images/Weather_g97-Storm_Sense_p16666.html
This year the weather patterns are constantly changing this year and as a chronic pain suffer, the constant change tends to cause me more pain.  Especially, on days right before a cold front or storm is on it's way.  Today is May 2nd and one would think that the weather would finally be on a consistent warming trend that usually takes place during the spring.  However, this year it seems as if winter will not go away.  Today its in the mid 40's and we are supposed to have a record low in our area tonight.

It seems as if my pain levels tend to change according to the weather.  In fact, my pain increases when it is cold or rainy outside.  Of course, my pain levels are also dependent on what I do throughout the day.

According to WebMD, the studies indicate that there is really no correlation between weather changes and pain levels.  But at a chronic pain suffer, it often feels as if the weather is in fact related.  Do you tend to agree?  

During bad weather or drastic weather changes the barometric pressure often changes right before it happens.  However, these changes are supposedly only slight changes.  When the barometric pressure changes, it changes the way the air moves around you.  When the air is heavier it is said to put more pressure on the body (this takes place when the barometric rate drops suddenly), causing your joints to swell slightly.  Scientist don't have any physical evidence that points towards a direct correlation.

Other medical experts think that many people are down and a person's mood changes, when it is rainy or cold.   This causes a person to become hyper focused on their pain or feel sorry for themselves which causes their pain to increase.  I notice that when it is cloudy, I tend to want to hibernate and hide under the covers to stay warm.  However, I don't find myself feeling down and out.  Do you think it is all in our mind?

Some even think that our increased pain is due to a flare up, that just coincidentally happened right before a storm or weather change.  While this may be true for one or two episodes, I don't feel that this is a good explanation for the increase pain.

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Does the weather affect your pain levels?  If so, how does it change your pain levels?